Herbal Diplomats: The Contribution of Early American Nurses (1830-1860) to Nineteenth-Century Health Care Reform and the Botanical Medical Movement by Martha M. Libster, PhD, RN. West Lafayette, IN: Golden Apple Publications; 2004. 384 pages, hardcover. ISBN 0-9755018-0-1. $37.00.

Author, nurse, and professor of nursing history at Purdue University, Martha Libster focuses on the healing work and use of botanicals by women in the United States during the mid 19th century (1830-1860). Dr. Libster, who holds a doctorate degree in Humanities and is an expert on the historical and contemporary integration of botanical therapies and nursing care, presents a most interesting history about herbal medicine during this time period. She also provides a valuable addition to the history of nursing in the United States, describing the roles of early nurses who provided health services to their communities. In recognition of its excellence, this book was awarded the 2005 Lavinia L. Dock Award by the American Association for the History of Nursing.

The women of this historical period bridged the gap between domestic and public domains by bringing to their communities the knowledge of health and healing through botanical remedies. The author describes in-depth case studies from 3 organized groups of nurses: Shakers, Latter Day Saints, and Sisters of Charity. These groups are representative of the early organizations of nurses in the United States. During the mid 19th century, there were few hospitals, and the role of nurses was that of a community resource or healer. The author situates the nurse's role in the cultural context of early 19th century when women's work was largely relegated to the domestic sphere, in contrast to men's work in the public spheres. Women's work had traditionally incorporated the health care of their families and members of their communities. Using detailed examples from these 3 groups, Dr. Libster asserts that these women acted as herbal diplomats by bringing the domestic knowledge of botanicals to the public. In keeping with their more domestic roles, the written historical accounts of these early herbal diplomats were not systematically recorded, as opposed to the healing practices of men. Thus, a good deal of the information comes from the "receipt book" journals in which women recorded some of their domestic exchanges, such as foods and healing remedies. Many of these receipt books contained case study notes about specific treatments. Additional sources of information came from letters, diaries, and organizational reports.

The author situates this kind of activity within its historical context. The political climate at this time was described as "Jacksonian democracy," one that valued self care, nature, and an agrarian economy. The practitioners of what was then considered conventional medicine (labeled the "Regulars") were moving toward a more scientific basis, oriented around the control or domination of nature. These practitioners were generally university educated and constituted a relatively elite class. This was the period of "heroic medicine," which refers to the use of treatments and medications with a powerful action. Their primary approach was to purify the body using the techniques of bloodletting and administering powerful emetics (which produced vomiting) and cathartics (which acted as powerful laxatives).

This was also a time of medical pluralism and several different groups of health providers were practicing. Dr. Libster describes the work of "Empirics," later called the "Eclectics," who embraced more natural cures and the use of botanicals. Most of Empirics did not have a university education. However, they were often very knowledgeable about botanicals or herbal medicine. One of the most prominent groups of health providers were the Thomsonians, who developed a "Materia Medica" based on botanical remedies from American Indian, immigrant, folk, and domestic remedies. Many of these remedies were patented and became known as "patent medicine." As America became more urbanized and industrialized, professional biomedicine emerged as the dominant practice, incorporating many of the botanical remedies into pharmaceuticals. Many of these early nurses worked with both the Regulars and the Empirics. Interestingly, many of the botanical remedies of that period were also aimed at catharsis, but were much gentler than the heroic practices of the Regulars. These remedies were often combined with tonics and botanicals with a more nourishing intent.

Dr. Libster explores the archives of 3 religious communities: The Shaker Infirmary and Community Nurses, the pioneer Nurses and Midwives of the Church of Jesus Christ of Latter-day Saints (Mormons), and the Sisters of Charity hospital nurses. She highlights both commonalities and differences in how nurses in these distinct organizations integrated healing practices from both the Regulars and the Eclectics. Dr. Libster describes their relationship to the Botanical Medical Movement (in particular Thomsonianism), and the American Indian healing practices related to botanicals. The author includes many botanical therapies, recipes, and remedies used for various ailments. This book illuminates how these nurses cast a more feminine approach to health and healing.

Herbal Diplomats is well-researched and extensively documented with numerous specific examples from each of the 3 exemplar groups. It makes an excellent contribution to women's history studies as well as illuminating the contributions of women and nurses to healing and the use of botanicals. This book contains interesting and relevant material for those interested in the history of herbal medicine in the United States. It also makes a much needed contribution to the history of the nursing profession by documenting this work of early nurses, prior to standardized education and professionalization. The author provides numerous references and admirable scholarship, which makes it an excellent reference book. It is recommended for both academics and the literate lay audience.

—Joan C. Engebretson, DrPH, AHN-BC, Professor, University of Texas Health Science Center at Houston, School of Nursing