Authors: Owen Whooley
WHOOLEY is assistant professor of sociology at the University of New Mexico.
The University of Chicago Press, Chicago 60637
The University of Chicago Press, Ltd., London
Â© 2013 by The University of Chicago
All rights reserved. Published 2013.
Printed in the United States of America
22 21 20 19 18 17 16 15 14 13Â Â Â Â Â Â 1 2 3 4 5
-13: 978-0-226-01746-4 (cloth)
-13: 978-0-226-01763-1 (paper)
-13: 978-0-226-01777-8 (e-book)
Parts of chapters 1 and 2 were published in “Organization Formation as Epistemic Practice: The Early Epistemological Function of the American Medical Association,”
33, no. 4 (2011): 491â511. Reprinted with kind permission from Springer Science+Business Media.
Library of Congress Cataloging-in-Publication Data
Whooley, Owen, author.
Knowledge in the time of cholera: the struggle over American medicinein the nineteenth century / Owen Whooley.
Includes bibliographical references and index.
978-0-226-01746-4 (cloth : alkaline paper) â
978-0-226-01763-1 (paperback : alkaline paper) â
1. CholeraâUnited Statesâ Historyâ19th century.Â Â Â 2. MedicineâUnited StatesâHistoryâ19th century. Â Â Â 3. Knowledge, Sociology of.Â Â Â I. Title.
This paper meets the requirements of
39.48â1992 (Permanence of Paper).
TIME OF CHOLERA
THE STRUGGLE OVER AMERICAN MEDICINE IN THE NINETEENTH CENTURY
THE UNIVERSITY OF CHICAGO PRESS
Chicago and London
my mom, Candie
conflict of ideas is a battle or series of battles, and presents all the meannesses, the cunning, the stratagems, the bitterness and sometimes the violence of actual war.
WILLIAM H. HOLCOMBE
President of the American Institute of Homeopathy, 1874 to 1876
The great fiction of intellectual life is that books usually bear a single name. All inquiry is communal, and all insight, interactive. This book is the sum of innumerable conversations, real or imagined, that opened my eyes, prodded me forward, and ultimately gave me great pleasure. More so than the final product, it is these conversations that I treasure.
For six years, I called the Department of Sociology at New York University my home. Jeff Goodwin constantly pushed me to keep the big picture in mind. Historical sociologists always run the risk of getting lost in the trees; Jeff helped me see the forest. Craig Calhoun provided me with generous support over my graduate careerâso generous that I will never be able to adequately express my appreciation. Always forthcoming in offering me the type of penetrating feedback for which he is well known, he has an uncanny ability to distill key points into a form digestible and understandable to all. Most of the more articulate points in this book can be traced back to him. Ann Morning has a calming presence that is contagious. She is a model of professionalism I can only hope to be able to shamelessly ape one day. To Troy Duster goes the credit of the most useful advice I received during this processâwrite, write, and then write some more. By reducing this project to the simple exercise of writing, Troy gave me the strategy by which I persevered. Ed Lehman, my reader, has been a constant mentor and friend. Vivek Chibber, David Garland, and Richard Sennett all at some point have read my work and provided invaluable feedback. Finally, I would like to thank the often overlooked administrative staff, who humored my pestering throughout the years, especially Dominick Bagnato, Candyce Golis, and Jamie Lloyd.
To have dear friends who are also your teachers is to be blessed. Jane Jones is the only person to have read every single word of every single piece
my research. She is the consummate editor; without her, my verbosity runs wild. I can never thank her enough for everything. Noah McClain, my fellow chronicler of the absurd, has been a steadfast source of support and much needed merriment. I cultivated my sociological imagination with him, as we subjected the most mundane and ridiculous topics to its wrath, over beers of course. Claudio Benzecry has given me so much advice and enjoyable conversation that I can only hope to someday return even half of it. I would also like to thank (and apologize to) that merry bunch in my writing workshop for enduring my long drafts with smiles of encouragement: Hannah Jones, Sarah Kaufman, Amy LeClair, Tey Meadow, Ashley Mears, Harel Shapira, and Grace Yukich. A special thank-you to Gabi Abend, Rene Almeling, and Andrew Deener, who helped see this book to fruition with prompt and penetrating feedback. Finally, I'd like to thank everyone who participated in NYLON with me, that cauldron of creative sociology, especially Ruthie Braunstein, Ernesto Castaneda, Monika Krause, David Madden, Erin O'Connor, Marion Wrenn, and Mark Treskon, who deserves special mention for constructing the fancy licensing map for the book.
Through the various accidents of my meandering biography, I have been fortunate enough to be a part of not one, but four excellent academic communities. I spent my first two years of graduate school in the Sociology Department at Boston College, and it was there that I figured out who I wanted to be intellectually. Bill Gamson, Char Ryan, and Diane Vaughan are the models of generous scholars. As a NIMH postgraduate fellow in the Institute of Health, Health Care Policy and Aging Research, I was granted the two most important ingredients for successfully writing a bookâabundant time and access to interested minds. I'd like to thank Allan Horwitz, David Mechanic, Deborah Carr, Gerry Grob, Eviatar Zerubavel, and my fellow fellows Ken MacLeish, Tyson Smith, and ZÃ¶e Wool. My current home is the Sociology Department of the University of New Mexico, where I look forward to years of sharing rarefied conversations with my new colleagues in the rarefied air of Albuquerque.
This book would not have been possible without the archivists and librarians who were more than willing to help me find that elusive document, despite my violations of certain library rules. Toiling away in anonymity, it is they who preserve our past, and for this, they should be celebrated. The staff at the New York Academy of Medicine, particularly Arlene Shaner, deserves much of my gratitude as we spent the better part of two years together. I'd also like to thank the staffs at the Bobst Library at New York University, the
Homeopathic Collection at the Taubman Health Science Library at the University of Michigan, the Butler Library at Columbia University, the New York History Society, the Parnassus Library at the University of CaliforniaâSan Francisco, and the Rockefeller Foundation Archive Center. Historical sociologists depend on the diligent research of historians who keep us honest and make sure we get the details of the story straight. I stood on the shoulders of many historian/giants, whose contributions deserve more recognition than mere references. Of note has been the scholarship of Harris Coulter, John Duffy, John S. Haller Jr., Howard Markel, Charles Rosenberg, and John Harley Warner. Finally, I'm especially grateful to editorâand keen witâDoug Mitchell, both for his encouragement and his sharp repartee; I am humbled that my book is now a small part of the indelible mark he has made on the discipline of sociology. Also at the University of Chicago Press, I'd like to thank Tim McGovern, Jennifer Rappaport, and Carol Saller.
Research, especially historical research, can breed insularity and can reward socially deviant behaviors. Fortunately, I am blessed with a rich community of loved ones, who couldn't care less about the ivory tower and who keep me grounded. My dad, Jim, was a dreaming empiricist and playful rationalist if ever there was one. It was he who taught me to approach the world with humble curiosity. While his death antedates this book, my writing is, and will always be, a conversation with him. My brother and best friend, Michael, is a source of constant laughs. He grounds me in who I am, and I couldn't imagine experiencing any of life's vicissitudes without him right next to me. My office mate and walking partner, Jibbs, is a constant source of delight. My closest friendsâSam Fillian, Karyn Miller, Elizabeth Pfifer Payne, and Mary Reganâare the most genuine people I have ever met. Erin Tarica, my wife and my word, is probably the only person to find my bookishness attractive, even generously misrepresenting it as “cool.” Her exuberance draws me out; her intuitive sensitivity is the perfect antidote to my excessive rationality. Words cannot express my feelings; hopefully, a lifetime of laughter will. Finally, this book is dedicated to my mom, Candie, who has been my greatest advocate and sturdiest support throughout my life. To merely thank her is inadequate; I am who I am because of her.
Of Cholera, Quacks, and Competing Medical Visions
When choleraâa disease never seen nor imagined by American physiciansâfirst arrived in the United States in 1832, the horrors it unleashed belied any pretensions doctors may have held to medical mastery. With its dramatic symptoms and rapid mortality, the foreign disease created widespread panic, which intensified as physicians' interventions did nothing to stem its progress. Worse still, physicians' heroic therapies, like bloodletting, sped the disease's course, undermining the ability of cholera patients to stave off death.
Cholera's ability to “mock the calculations of man” (Short quoted in Chambers 1938, 164) generated a crisis in medicine as doctors scrambled impotently to find a cure for the unfamiliar disease. Their failure to do so seriously compromised the public standing of the medical profession. By the 1830s, allopathic or regular physiciansâthat is, the dominant sect of physicians later represented by the American Medical Association (AMA)
âhad gained a measure of professional control, as thirteen state legislatures had passed medical licensing laws (Numbers 1988). These laws represented early cultural validation, a crucial step in the consolidation of professional authority. Cholera destroyed this momentum. Alternative medical movements pointed to allopathy's failures during the cholera epidemic to mount a campaign to repeal the licensing laws. And by the mid-1840s, merely a decade after they had been passed, the licensing laws were universally repealed (the one exception being the New Jersey statute). Cholera became a symbolic failure for allopathic medicine that ushered in an era of unregulated medicine and intense competition among medical sects.