Knowledge in the Time of Cholera: The Struggle over American Medicine in the Nineteenth Century

Knowledge in the Time of Cholera: The Struggle over American Medicine in the Nineteenth Century

Owen Whooley

Language: English

Pages: 328

ISBN: 022601763X

Format: PDF / Kindle (mobi) / ePub


Vomiting. Diarrhea. Dehydration. Death. Confusion. In 1832, the arrival of cholera in the United States created widespread panic throughout the country. For the rest of the century, epidemics swept through American cities and towns like wildfire, killing thousands. Physicians of all stripes offered conflicting answers to the cholera puzzle, ineffectively responding with opiates, bleeding, quarantines, and all manner of remedies, before the identity of the dreaded infection was consolidated under the germ theory of disease some sixty years later.

These cholera outbreaks raised fundamental questions about medical knowledge and its legitimacy, giving fuel to alternative medical sects that used the confusion of the epidemic to challenge both medical orthodoxy and the authority of the still-new American Medical Association. In Knowledge in the Time of Cholera, Owen Whooley tells us the story of those dark days, centering his narrative on rivalries between medical and homeopathic practitioners and bringing to life the battle to control public understanding of disease, professional power, and democratic governance in nineteenth-century America.

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deregulated; and an epistemic contest was born. o f c h o l e r a, q uac k s, a n d c o m p e t i n g m e d i c a l v i s i o n s | 27 | Chapter 2 describes the allopathic response to the democratic challenges of alternative medical sects, particularly homeopathy. A er the 1848 epidemic, allopathic reformers redefined the identity of regulars, embracing a radical empiricism inspired by the Paris School of medicine. While this shi ostensibly allowed allopaths to claim some democratic bona fides,

historians have o en resorted to macro-cultural explanations to explain the licensing repeals, viewing the deprofessionalization of allopaths as caused by the changing cultural winds, with the spirit of Jacksonian democracy serving as the catalyst for revolts against professionalization (e.g., Marks and Bea y 1973; Rothstein 1992; Starr 1982). Such macro-cultural accounts misleadingly marshal Jacksonianism as a causal explanation for its very components. But macro-cultural shi s do not exist in

much progress along any of these lines (see Fishbein 1947; Porter 1998). Indeed, the early period of the AMA, from roughly 1840 to 1880, witnessed the declining status of the profession (Numbers 1988). While correct in pointing out the AMA’s inability to achieve its specific professional goals during its first fi y years, these accounts overlook an important epistemological function of the early AMA. is oversight is not just a product of damning historical evidence; it stems from the way in which

to regulars’ professional goals as it frustrated their a empts to gain control over public health. e second section of this chapter discusses the internal struggles over control of the Metropolitan Board of Health first between regulars and other sanitarians, specifically plumbers, and then between regulars and homeopaths. Allopathic physicians could not exclude nonmedical experts because the broad framing of disease as filth required the input of a number of actors, everyone from civil engineers

resolve the status of Koch’s research within homeopathy and prevented its full transformation into a singular homeopathic discovery. Allopathy’s Narrative of Emergent Discovery—Prior to the bacteriological revolution, allopathy embraced a radical bedside empiricism, selectively translated from the Paris School. In their repudiation of the rationalist systems of the early nineteenth century, allopathy sought to purge medicine of all speculative hypotheses and theories by making individual sensory

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