Doctoral Dissertation Research: Cholera and Quacks: The Struggle Over 19th-Century Medical Knowledge

New York University, New York NY

Investigators

Abstract

This Science, Technology & Society Doctoral Dissertation Research Improvement Grant seeks to explore the scientific development of cholera and its relationship to the professionalization of medicine in the nineteenth century United States. During this period, orthodox medicine experienced a profound shift in professional authority. Although alternative medical groups successfully challenged orthodoxy in a number of institutions during the mid-1800s, at the turn of the century, orthodox physicians redefined their expertise under bacteriology, creating a powerful, autonomous profession. This project seeks to answer how orthodox physicians were able to consolidate their professional authority, which had been lost in the early 1800s, under the bacteriological paradigm. The dissertation project examines cholera as a case study of an "epistemic contest" where collective actors with competing paradigms struggle for recognition in various institutions. More than knowledge on cholera, at stake in this epistemic contest was the definition scientific medicine (i.e. how and by whom legitimate medical knowledge should be attained). Through a study of archival records from relevant institutions and medical groups, the project traces shifting conceptions of cholera in order to: 1) reconstruct the evolution of the epistemic contest, 2) elucidate the epistemologies propagated by different medical sects, and 3) examine the efficacy of the cultural strategies used to promote these epistemic positions. It hypothesizes that orthodox medicine was defeated in public institutions because the transparent epistemologies of alternative medical sects resonated better with these public institutions. Regulars only achieved control over the definition of cholera by insulating the debate from public scrutiny, convincing a small group of elites (i.e. the Rockefeller and Carnegie Foundations) to support their professional project outside of government institutions. This research challenges traditional diffusion models of knowledge by systematically investigating the role of extra-scientific polemics. By introducing the concept of the epistemic contest, this research explores how scientific knowledge of disease is obtained, verified, and legitimated within public institutions.