Knowledge in the Time of Cholera: The Struggle over American Medicine in the Nineteenth Century
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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.
professional authority that they remained unchallenged by even the most deadly of epidemics. Operating under the banner of science and the bacteriological paradigm, allopathic physicians had wrested control of medicine from competing sects, winning recognition as the experts in treating, controlling, and understanding disease. e medical profession emerged from the inﬂuenza epidemic as inﬂuential as ever. Two epidemics, two conspicuous failures, and yet two widely divergent professional
L U S I O N: K N O W I N G I N D E M O C R AT I C S PA C E S Disputes over licensing laws followed a similar pa ern in other states, producing time and again the same outcome of repeal (see table 1.2).11 Alabama and Ohio repealed their laws in 1833, hardly waiting for cholera to even clear out. From there, repeal spread throughout the thirteen states that had licensing laws on the books. In Georgia, alternative medical sects argued that licensing laws were monopolistic and ultimately detrimental
or control the earliest outbreaks of the disease” (emphasis added). Because the association of cholera with ﬁlth did not require the commitment to a causal understanding of the relationship, it united strange bedfellows. As the New York Times (July 1, 1866, 4 emphasis added) pointed out in discussing the New York Academy’s support of sanitary reforms in New York City, e camps of the medical world are divided on this disease, as on many others, into two hostile parties, for and against contagion;
epistemology. Epistemological change is viewed as following from new discoveries. A microbe is seen; the lab is embraced. is, however, inverts temporal directionality. Before a microbe can be seen or produced in the lab, there must exist a predisposition to seeing it, an adoption of particular epistemological assumptions that would enable physicians and researchers to recognize a discovery as such. Epistemological commitments precede facts, not the other way around. Inverting this temporality
supplied this rationale. Even if this justiﬁcation was contested, it was a justiﬁcation nonetheless. Still, to consolidate control over Koch’s research and its status as a discovery, young elite reformers within allopathy began a conscious program of building networks with German laboratory science. As the previous generation had traveled to Paris for advancement, a new cadre of elite doctors traveled to Germany to learn under Koch, creating an “invisible college” (Crane 1972) of bacteriological