Over the years, I’ve heard mention of a homeopath, a Dr. Allan Sutherland, who practiced in Brattleboro in the not so distant past. Usually it was from one of my patients who recalled being attended by him in childhood. Once a Brattleboro native now living in Connecticut noticed my sign and decided to stop in just to tell me about her childhood homeopathic physician whom she had greatly admired. Another time, it was a naturopath from Colorado who told me he had spent two years in Brattleboro apprenticing with. Sutherland in the last years of the doctor’s life.
I have conceived of him not only to be a predecessor, but also something of a kindred spirit. Along with my own father, a small town general practitioner himself, I have long imagined Dr. Sutherland being a personal exemplar of the medical profession – even though I really knew next to nothing about the man himself.
So, it was with great interest that I came across recordings and a transcript of an interview with the good doctor conducted in 1968 by a Dr. John Huffy and his assistant, Martin Kaufman. It is contained in a library of oral histories on the website of the US National Library of Medicine, which is a branch of the National Institute of Health.1 Sutherland’s is one of some 50 or 60 conducted with medical people who practiced in the early to mid 20th century. A number of them are homeopaths whose names I recognize as leaders in the field at that time.
Ironically, the list also contains the name of the notorious Morris Fishbein who controlled the AMA as well as edited its Journal for a quarter of a century. He accrued great power and wealth for the organization and himself by some rather dubious means and was eventually indicted for racketeering. He was also virulently opposed any practitioner, homeopaths included – perhaps homeopaths especially - who did not conform to his conception of orthodoxy. Indirectly, Fishbein through his various machinations would have a profound effect on Sutherland’s life.
The fact that Sutherland was included in this group would indicate that he was, in addition to being a small town doctor, also a prominent member of itself became in the United States starting well before the Civil War and the significant role it played for well over a century.
Abraham Lincoln appears to have been quite interested in and a supporter of homeopathy.2 John D. Rockefeller was a believer, calling it ‘a progressive and aggressive step in medicine’ and receiving homeopathic care until he died at the age of 99.3 The same can be said of Mark Twain, who wrote, “The introduction of homeopathy forced the old school doctor to stir around and learn something of a rational nature about his business. You may honestly feel grateful that homeopathy survived the attempts of the allopaths to destroy it.” 4 Unfortunately, the great Twain spoke prematurely.
Allan D. Sutherland was born in Northfield, Vermont in 1897, delivered by the local homeopathic physician. The son of a Canadian Episcopalian minister, his father had arrived there to lead the local parish five years earlier and met his mother, who was the daughter of the president of the University of Norwich. Four years after Allan’s birth, ministerial work lead the family first to North Carolina and then to Connecticut a few years afterward.
The boy’s first real experience with medicine came when he developed abdominal pains that demanded immediate attention. The family had traditionally been attended to by homeopaths, but had not yet found a homeopath in Connecticut. The local physician, an older orthodox physician, was first called to the home but apparently could not diagnosis the condition. So, they sent for a homeopath from some distance away who had once practiced in Brattleboro. This man not only knew the family from their Vermont days, but also supposedly had once been a suitor of Allan’s mother during a period when she had also lived in Brattleboro.
That man, it turns out was Herbert A. Roberts, one of the preeminent homeopathic physicians of his era renowned for his mastery of homeopathic philosophy. He was a prolific writer, publishing a number of books and hundreds of article in journals. Roberts also assumed a leadership role in several homeopathic organizations as well as reputedly being the only American homeopath to serve as a medical officer during WWI.
One of the very first books on homeopathy that I encountered and that still remains one of my favorites is Robert’s ‘The Principles and Art of Cure by Homeopathy’. The first chapter, entitled ‘What Has Homeopathy To Offer The Young Man?’ particularly spoke to me. Anyone – man or woman – aspiring to the profession woulddo well to acquaint his or herself with it.
Roberts diagnosed Sutherland’s illness as acute appendicitis and called for a surgeon as the condition apparently had lingered on past the point where he could treat it. The surgeon arrived from New Haven and operated on the boy on the kitchen table. Evidently, traveling surgeons were still common in the early 20th century, however unthinkable the notion seems to us today.
The surgeon found the appendix to be gangrenous and did not want to remove it for fear of it bursting during surgery and causing a fatal generalized infection. So, the appendix was drained, the inflammation calmed down and the boy recovered.
Unfortunately, Sutherland became ill again a year later while the family was vacationing in Brattleboro. The family doctor in Brattleboro at the time was a homeopath named Henry Tucker who sent him to the hospital where finally his appendix was removed once and for all.
Sutherland recalled how both Tucker and the surgeon at the hospital ‘had a way with children’ and stated that it really was his desire to emulate these kind men that made him aspire to be a physician himself.
PART II
In 1910, Allan Sutherland was a 13 years old living in Connecticut. That was the same year that an educator named Abraham Flexner was chosen by the president of the Carnegie Foundation to make a study of the state of American medical education along with recommendations to reform it. Flexner was not a physician. In fact, he had ‘never stepped foot inside a medical school’.5Nevertheless, he was chosen based on a critique of higher education he authored two years earlier entitled ‘The American College’.
The Carnegie Foundation had been charged with this responsibility by the Council on Medical Education, which itself had been formed by the American Medical Association in 1904.
The outcome of his study, known as the Flexner Report, had an immediate and far-reaching influence on American medicine, the repercussions of which are still felt today. It also would profoundly impact the professional career of the aspiring physician-to-be.
At the time, many of the medical colleges throughout the country were relatively small establishments, more akin to what we might think of as trade schools today than institutions of higher education. There was a tremendous amount of disparity amongst them in terms of curricula, facilities, faculty qualifications, affiliations with hospitals, and standards for students. A great number were profit making and conferred degrees after two years of study.
To conduct his research, Flexner reportedly visited all of the extant 155 medical colleges. He concluded that 80% of them needed to be closed and that the overall number of medical students be reduced. Flexner also recommended that prerequisites for admission be raised, that medical schools have control of clinical instruction at hospitals, that faculty be engaged in research not full-time practice, and that medical licensure be state regulated. From a modern perspective, perhaps the most significant aspect of the report was that he strongly advocated for all medical schools to train physicians according to the ‘scientific manner’.
The dramatic changes precipitated by the adoption of these recommendations brought about a wholesale reorganization of not only medical education, but also medicine as a whole. It transformed the profession economically, sociologically as well as philosophically. The elevation of admission, educational and facility standards no doubt was a much-needed reform but there were also a great many negative consequences.
For instance, opportunities for women and blacks to be trained as physicians were dramatically reduced. In the largely segregated world of that era, there had been a number of medical schools for black students that, with the exception of only two institutions, were all closed.
Similarly, female medical colleges were largely closed. (The first female medical college in the world was the Boston Female Medical College, a homeopathic institution founded in 1848. The homeopathic profession as a whole was at the forefront of providing educational and professional opportunities to women in the 19th and early 20th century). In addition, the reduction in the number of medical students had a disproportionate negative affect on women admitted because male students were given priority.
Just as damaging were the ramifications of Flexner’s interpretation of ‘scientific’. Though not a medical person, he had an antipathy toward systems of medicine that seemed unscientific to him – that is, toward forms of medicine he did not understand.
This included chiropractic medicine, osteopathy, naturopathy, and homeopathy, amongst others. Schools that taught these modalities were given an ultimatum to comply with demands to adopt a curriculum that emphasized a reductionist, mechanistic medical model (the ‘scientific modal’) or else lose accreditation.
Each of these professions adapted to the recommendations of the report differently. The osteopathic colleges were for the most part able to successfully comply to the extent that many osteopathic graduates to this day practice mostly or even exclusively orthodox medicine and little or no osteopathy.
The chiropractors maintained a parallel system of education, and embarked on a decades long struggle for vindication which they ultimately won when a federal judge found the AMA guilty of conspiring to destroy the profession in 1987. The naturopathic movement became dormant for decades only to resurface in the 1950’s with the founding of the first naturopathic medical college.
In contrast, the homeopathic profession was by in large unable to reconstruct itself to successively survive the reforms. There were many reasons for this including basic irreconcilable differences between what the orthodox and homeopathic physicians deemed as ‘scientific’. Another point of contention was the emphasis Flexner placed on medical educators being more involved with research and less so with clinical practice. In contrast, homeopathic educators strongly believed that continued involvement in daily practice was essential for their instructors.
Perhaps most fundamentally, the problem lay in the fact that the homeopaths were now being brought under the governance of the American Medical Association, to which the Flexner Report had delegated the responsibility for regulation of medical licensure.
This was an organization created in the 1840’s for the express purpose of combating the rising tide of homeopathy that had swept across the country at that time. There was a long history of hostility directed at the homeopaths - to the extent that not only were homeopathic physicians disparaged and excluded from the organization but also any orthodox physician who consulted with a homeopath was censured or, in some instances, expelled.
As a result of the Flexner report and the consequent reforms, of the 22 homeopathic medical colleges that existed at the turn of the 20th century, only 2 survived beyond 1920. One of these was Hahnemann Medical College, generally regarded as the flagship institution of the profession in the United States. Founded in Philadelphia during the 1840’s by Constantine Hering, the ‘Father of American Homeopathy’, it had adapted its curriculum sufficiently to meet the Flexner’s stipulations and thus its status as a ‘class A’ medical school. (It was also the last homeopathic medical school to close its doors in the 1940’s.)
The grandson of a college president, Sutherland had been sent to the Kent School, a ‘college preparatory school’ or what today would call a boarding school, and then onto Yale University to do his premedical course work. After his freshman year, his education was interrupted due to military service during the First World War. Returning to Yale afterward, he completed another year and a half, but poor midterm exam results doomed his career there.
Worried that he no longer qualified for medical school, he went to work. But as fate would have it, Sutherland ran into Dr. H. A. Roberts, one of the physicians was who had attended to and inspired him when he was ill. It was the suggestion of this nationally renowned homeopath and family friend to apply to Hahnemann College since, in addition to the medical school, the school also had a premedical science division where he could finish his prerequisites.
PART III
Starting in 1920, Sutherland began his premedical studies and a year later, he began his medical education at Hahnemann Medical School in Philadelphia.
Although homeopathy was still a mainstay of the curriculum, to comply with the mandate of the Flexner Commission the focus was increasingly placed on orthodox medicine. Looking back nearly 50 years later, Sutherland reflected, “We weren’t taught as well as we might have been in the homeopathic field there…”6 By that point in time, it seemed many of the instructors were neither particularly good, or even practicing, homeopaths.
But Sutherland was able to overcome these educational deficits by staying in Philadelphia after his graduation in 1925 to intern at both Children’s Homeopathic Hospital and St. Luke’s Homeopathic Hospital. He then was appointed the chief resident at Children’s for ‘the magnificent sum of 100 dollars a month’. With the conclusion of his residency and 2 years of clinical experience under his belt, Sutherland opened his own practice in Philadelphia while retaining a position at Children’s in the Obstetrics and Gynecology Department.
In 1928, his aunt wrote that if we interested in returning to New England, there was a good opportunity in Brattleboro, VRT. At the time, there were 10 medical doctors practicing in town - two of them homeopaths and the remainder orthodox physicians. But now one of the homeopaths was retiring and the other had recently died. In addition, one of the orthodox practitioners was an alcoholic and another other hospitalized for drug addiction. Sutherland decided to take advantage of these circumstances y to set up practice in Brattleboro.
At the time, the population of Brattleboro was about 10,000 people. So, there was about one doctor per thousand people – and probably less if one were to consider the outlying rural areas whose population was more than likely served by the physicians in town. It is interesting to reflect on how the medical infrastructure and services have grown since then even though the population is approximately the same. Today, Brattleboro Memorial Hospital alone has approximately 80 medical doctors on its staff.
At one point in time, there were also some 60 or so homeopaths practicing throughout Vermont. By the time Sutherland moved to Brattleboro, there were only about 16, mostly elderly men. This was yet another indication of the legacy of the Flexner Commission and the subsequent collapse of homeopathic educational institutions. But there was still an active state homeopathic society, which he joined as its youngest member.
During this era, the homeopaths were still integrated into the medical profession at large. Indeed, Sutherland saw himself as a physician first and a homeopath second, or perhaps it would be more accurate to say he was a physician whose tools of practice were homeopathic. By his own account, the relationship between himself and his orthodox colleagues was good. He was on the staff of the hospital and joined the Windham County Medical Association. In fact, he soon was elected the secretary of the Association.
At the time, the Vermont Board of Medical Registration (now known as the Board of Medical Practice) also had a provision that along with five orthodox physicians, two homeopaths and one ‘eclectic physician’ (a now discarded term for physicians who primarily used herbal medicines and other natural techniques, and were the antecedents of today’s naturopaths) be included. Several decades after opening his practice in Brattleboro and being one of the three homeopaths left practicing in the state, Sutherland was appointed to Board. He would eventually serve as its president.
The life of a small town general practitioner, homeopathic or otherwise, in the first half of the 20th century was not an easy one. Physicians maintained solo practices and took on full responsibility for their patients. House calls, hospital rounds, and office hours made for a demanding schedule, not to mention the not infrequent emergency calls that needed to be attended to in the middle of the night.
These were in the days before antibiotics when acute infectious diseases were life and death matter, when a bout of influenza or pneumonia could be fatal. Sutherland was confident in his skills and the outcomes of his cases compared favorably to orthodox practitioners of the time. But looking back on it, Sutherland described it as a rat race, and that he ‘sweat blood” – that it was his, or any physician’s, obligation to sweat blood – to bear these responsibilities.
And for all of that, it was not a particularly remunerative profession, at least by the standard we associate with medical practice today. He was not able to maintain membership in various homeopathic associations or to travel to their conferences for lack of funds. It took a decade into practice before Sutherland was able take advantage of the opportunity to attend special courses given by his old family friend and mentor, Dr. H. A. Roberts.
As the older generation of homeopaths in Vermont and the nation as a whole gradually disappeared, one can imagine that the burden of practice must have been especially great because, though still integrated into the medical community at large, he increasingly lacked colleagues whose practice mirrored or understood his own.
As the years passed, Sutherland adjusted to the ongoing pressures of practice and to the transforming medical environment by making changes of his own.
PART IV
When Allan Sutherland was born at the turn of the 20th century, homeopathy was arguably at its zenith in the United States. There were numerous homeopathic hospitals, over twenty homeopathic medical schools and nearly one in four physicians was a homeopath. When he entered homeopathic medical school after the First World War, the profession was already in decline as the effects of the Flexner Reports anti-homeopathic bias and the subsequent closure of many homeopathic facilities took their toll.
It is a great irony that it was just around this time, that homeopathy had perhaps its greatest therapeutic success in the 20th century. The Spanish Flu, the great pandemic that struck half a billion people worldwide and killed somewhere from 50 to 100 million of them, arrived in North America in several waves – the first of which was during the spring of 1918. About a quarter of the population in the United States caught it, and the mortality rate was in the neighborhood of 30 per cent - somewhere over a half million persons.
Orthodox medicine was helpless to treat it, and, in fact, the one medicine that was generally prescribed to patients probably aggravated their condition. Bodies piled up in the streets, large X’s were marked on the doors of the afflicted. It was a scene we might associate more medieval plagues than 20th century America.
In contrast to these dire outcomes, homeopaths throughout the United States were having quite different results. Dr. H. A. Roberts of Connecticut, Sutherland’s old family physician and his future mentor, who treated soldiers suffering from the flu while working as a physician on a troop ship, had collected outcome data from 30 homeopathic physicians around Connecticut. He reported that of the 6,602 cases they treated cumulatively only 55, or less than 1 per cent died.7 A dean of the Hahnemann homeopathic medical school, W. A. Pearson collected data on over 25,000 cases from around the country with similar outcomes and mortality rates.
Of the cases that were lost, the physicians consistently pointed to one common factor. A typical observation was that of Dr. J. P. Huff from Kentucky: “I hardly ever lost a case if I got there first, unless the patient had been sent to a drug store and bought aspirin, in which event I was likely to have a case of pneumonia on my hands.”8 Orthodox physicians, powerless to cure the illness, were prescribing aspirin as a means of suppressing the symptoms. They were also suppressing the immune system of their patients and unwittingly predisposing them to fatal outcomes.
In the light of the yeoman service provided by the homeopaths as well as documented proof that homeopathy in the hands of well-trained practitioners had more than proved itself, it might have been reasonable to expect a reconsideration of its place in the medical firmament of the United States. But no such reappraisal ever took place. To those in positions of authority the theory of homeopathy was opaque and unscientific. It therefore was a form of charlatanism or, at best, placebo and evidence to the contrary was simply ignored.
By the 1950’s, with its infrastructure long since destroyed, the homeopathic profession was withering on the vine. Allan Sutherland, who had once been the young Turk of the Vermont homeopathic profession, was now, after close to three decades in practice, the last man standing. From 60 to 16, and now there was just him.
The challenge of homeopathic practice, and no doubt one of the reasons that many physicians then and now are reluctant to embrace it, is that each case needs to be individualized. In each case, the physician needs to finds the characteristic way in which the patient is responding to the disease. ‘Routine’ prescribing, that is, the rote repetition of prescribing the same medicine to every person with the same illness does not lead to positive outcomes.
On top of the 30 years of ‘sweating blood’ -house visits, hospital rounds and calls in the middle of the night, he was increasingly isolated as a practitioner. Although he considered orthodox physicians his colleagues, the reality was that he was alone in his practice. There was no one to bring in to consult on difficult cases, no one to cover if he was not there.
This was a situation that was only going to get intensify as time went on. He couldn’t imagine, he said, running around making house calls at the age of 85 to support his family. So, in 1953, Sutherland made a dramatic change that provided him with greater security and reduced work responsibilities. He accepted a position on the staff of the Brattleboro Retreat as a staff physician.
The Retreat, founded in the 1830’s as the first mental health hospital in the state and one of the first private mental health hospitals in the country, had a patient population of three hundred and fifty. Sutherland tended to the physical ailments for about 125 chronically ill men, saw some patients in the out-patient department and ran an in-house clinic for Retreat employees.
To a certain extent, he did prescribe homeopathic remedies for his patients there, but also worked allopathically. For a number of years, Sutherland maintained his old practice in the evenings so he could cater to the people who had doctored with him over the years. But slowly, the hours reduced and by the time he turned 70 that too was terminated.
In spite of these changes, Sutherland’s involvement with homeopathy continued. Long deprived of local colleagues, he had participated first in statewide and later in national homeopathic organizations for many years. As it always seemed to happen in any organization he joined, be it homeopathic or orthodox, Sutherland rose to a leadership position.
He became a leading teacher at a course run annually by the American Foundation for Homeopathy and later the National Center for Homeopathy. Compared to the now vanished four-year homeopathic medical colleges of his youth, these courses were modest offerings of six weeks. But they played a crucial role in keeping alive the flame of homeopathy during a very lean period that extended for nearly three decades.
As the old homeopaths that trained in the early 20th century slowly disappeared and awareness of homeopathy in general receded, it was left to a small community of adherents to maintain its continued existence in this country from the 1940’s thru the 60’s. They were a mixture old timers like Sutherland and younger physicians who had somehow come in contact with homeopathy and recognized its value. And there were an increasing number of laypersons that felt a philosophical affinity to this effective but gentle medical science.
After earlier parts of this article were published locally, I received an email from David Sutherland, the younger son of Allan who lives in Keene, NH. I had heard that a son of his still lived in the area, and was excited that he made the effort to make contact and even suggest that we get together.
Over a restaurant dinner with our spouses, he shared memories of his father, showed me some pictures and lent me copies of a journal that contained articles penned by his father. An engaging and young looking 70, David reminisced fondly about summers spent in Millersville, Pennsylvania where the summer homeopathy courses took place and where his father had brought the family for the duration.
In the recordings I had listened to, Allan Sutherland never expressed any enmity or malice toward the orthodox medical profession per se, though he clearly did not hold the American Medical Association – which had actively tried to crush homeopathy and other non-orthodox practices – in high regard. Ironically, Sutherland expressed more disdain toward some of the lay homeopaths that he felt were both under trained and overly idealistic about what homeopathy could and couldn’t do.
When I brought this up to his son, David replied simply that his father was not a man who harbored ill will. It wasn’t part of his nature. He further related that in the last decade of his life, the years after the NIH recording was made, his father was sought out by a new generation of students who gathered at the family home to learn from him.
It must have been quite gratifying to recognize that the lean years were coming to an end, that, in fact, throughout the United States there was a budding renaissance in the homeopathic movement and that he had been one of those responsible for it.
1. (http://oculus.nlm.nih.gov/cgi/t/text/text-idx?page=browse;c=oralhist
2. http://www.huffingtonpost.com/dana-ullman/abraham-lincoln-homeopathy_b_2177808.html
3. http://sueyounghistories.com/archives/2007/08/28/john-davison-rockefeller-senior-and-homeopathy/
4. http://www.homeopathic.com/Articles/Media_reports/Quotes_in_Support_of_Homeopathy.
html
5. http://en.wikipedia.org/wiki/Abraham_Flexner
6. Op. Cit
7. “Influenza-1918: Homeopathy to the Rescue”, by Julian Winston, The New England Journal of Homeopathy, Spring/Summer 1998, Vol.7 No.1
8. Ibid.