There’s no doubt about it, medicine has come a long way over the past century. But, ask Wisconsin historian and author Erika Janik and she’ll tell you, medicine in the 19th century wasn’t all snake oil and trickery.

In fact, many of the ideas we now embrace – herbal remedies, drinking a lot of water, chiropractic care, regular exercise, massage therapy – were born out of 19th century practitioners who were considered outcasts in their day.

While Publisher’s Weekly says Janik’s "Marketplace of the Marvelous: The Strange Origins of Modern Medicine," is "a must-read for medical history buffs," the book is, in fact, a fascinating and readable look into the roots of modern medicine, with some bonus ties to Wisconsin for hometown readers.

We caught up with the Madison-based Janik – who is also the author of "A Short History of Wisconsin," "Odd Wisconsin" and "Madison: History of a Model City," among other works – to discuss the new book, which is published in hardcover by Beacon Press.

OnMilwaukee.com: How did you come to the subject of the new book?

Erika Janik: This book really began with two things: an article from the archives of the Journal of the American Medical Association congratulating the state of Wisconsin for finally capturing the Reinhardt brothers of Milwaukee, and the unexpected discovery that my great-grandmother practiced a form of hydrotherapy, or water cure, in Chicago in the early 20th century.

I ended up co-writing an article on the Reinhardts with my husband for the "Wisconsin Magazine of History." This research led me deep into what we now call alternative medicine but what was known as "irregular" medicine in the 19th century. I discovered a world filled with quirky characters with big ideas and irregular healing practices that welcomed women as professional doctors long before they were welcomed into mainstream medicine. I love offbeat stories, utopian ideas and women in unexpected places.

OMC: Do you have any connections to medicine, other than as a user, like the rest of us?

EJ: My husband is a physician, or a regular doctor as I would call him in the book, with a deep interest in history. His input was invaluable to me even as we disagreed about certain points. His insights certainly pushed me to a deeper understanding of medicine and made me think twice about my assumptions. I think my research changed the way he thinks about his field – or at least I hope so!

OMC: It's a little off the beaten path for you, isn't it, given that your previous books were usually about Wisconsin history?

EJ: Yes and no. Unusual characters, odd ideas, and women’s history have figured into all my work. My training as a historian is also in women’s history and colonial and early America. It’s true that I haven’t written a book on medical history before but so many of the things I love about reading and writing history loom large in this story.

OMC: Does Wisconsin figure in this one, too?

EJ: Absolutely. Irregular medicine was wildly popular all over the country. We had water cures, phrenologists, osteopaths and the whole lot. The Reinhardts also make an appearance because they are too good to leave behind.

OMC: Can you talk a bit about modern medicine's roots in homeopathy?

EJ: Homeopathy is based on two theories: the law of similar, or "like cures like," which is the idea that a disease can be cured by a substance that produces similar symptoms in healthy people; and the notion that a lower dose is more effective than a larger one. Homeopathy’s founder, Samuel Hahnemann, put his remedies through a fairly rigorous testing process for the time that was far more scientific than regular medicine. He tested them first on healthy people to make sure they were safe before giving them to sick people – that’s just the way clinical trials are done today.

The scientific rigor of homeopathy pushed regular medicine toward more scientific methods of their own. Homeopathic medicines also tasted good and were nearly pain-free doses, introducing the novel idea of healing without pain. We now expect medicines to come with few, if any side effects, but in the 19th century, painful side effects were considered normal.

OMC: Was there at point at which homeopathy was more trusted than medicine and a point at which the inverse became true? How did that happen?

EJ: There was definitely a time when homeopathy posed a significant threat to mainstream medicine. Its popularity among middle and upper class Americans decreased the earnings and influence of regular doctors until late in the 19th century. The germ theory of disease, the introduction of sterile surgery and advances in lab science began to change homeopathy in the 1880s and 1890s.

Mainstream medicine changed, too, in response to these discoveries. Many homeopaths embraced scientific advances that eventually eroded the very ideas that made homeopathy unique. By the 1920s, homeopathy on the academic level at least had converged to the point of disappearing within regular medicine.

OMC: Modern medicine also has roots in the snake oil salesmen, too, right?

EJ: Medicine was a wild place in the 19th century. We didn’t know about germs or how human contact could spread disease, and medical licenses were generally not required to practice medicine. Both untrained and trained doctors sold "snake oil" or patent medicines with secret ingredients and mysterious names that they advertised in newspapers and magazines.

Medicine was not the lucrative profession it is today so many doctors were entrepreneurial and sold their own brand of medicine. It’s hard to know the intentions of people in the past and just as surely as their were swindlers out to make a buck off the gullible, there were also honest businessmen trying to sell something they believed worked to sick people.

OMC: There are a number of modern medical "truths" – like drinking a lot of water, regular exercise, massage, herbal remedies – that were considered craziness at one point, too, right? Would a doctor from, say, the 1850s, think we're all nuts now?

EJ: Probably. Many of our modern ideas of health and wellness come out of the 19th century. A whole field of medicine, hydropathy, for instance, was devoted to the benefits of cold water to health, even promoting the idea of drinking 8-10 glasses of water a day. Regular bathing was fairly uncommon among 19th century Americans so the hydropathic idea of bathing and drinking water was pretty out there.

The same was true of herbal remedies and natural healing, something promoted in the early 19th century by Samuel Thomson. Doctors thought all these healers were nuts, and would likely be surprised to see us following so many of these irregular ideas to this day.

OMC: What were some of the biggest surprises for you as you researched the book?

EJ: The biggest surprise – and certainly most pleasant given my interests – was how many women became irregular healers. Medicine was second only to teaching in attracting women to the profession. Many women struggled to get the medical care and attention they needed from their male doctors.

Propriety kept these doctors from fully examining them and almost no one spoke about women’s health. Into this gap strode irregular healers who saw an unmet need among the population and not only treated women but also welcomed women in as professional doctors in their own right. Homeopathy, for example, welcomed women into their national professional organization in 1871; the American Medical Association would not do the same until 1915.

OMC: What are the lessons we can take from this history?

EJ: I think the biggest lesson is that alternative medicine isn’t new and the sense of newness attached to it is far greater than deserved given its long history. Americans have used and sought out many forms of medical care for centuries: choice is what we want.

Medicine has certainly made great strides, vastly improving public health and increasing our life expectancy, but holes remain both in our knowledge and in the quality of care. Irregular or alternative healers have demonstrated their ability to help people feel better whatever the mechanism – and it may be placebo – but there is something about it that works for people.

Asking ourselves why and what continues to make alternative health so attractive seems like an important aspect of improving medical care for all.

OMC: Are you working on something new now that you can tell us about?

EJ: I am researching and beginning to shape my ideas for a new book filled with women in unexpected places and more of the quirky stories that make history so appealing to me.