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MEDICAL MARKETPLACE

12 May

Orthodox doctors constituted the majority of nineteenth-century medical practitioners, but popular  health  reformers  and members of competing sects,  generally  known  as  irregular   practitioners,  did  manage   some effective challenges to their authority. Orthodox practitioners generally shared  one view of alternative  practitioners; they saw them as quacks, frauds, and deviants, even if such practitioners began their career as phy- sicians. Quacks who really believe in their unconventional methods might be considered foolish, misguided, or deranged,  while those who engaged in  deliberate   deceptions,   were  called  charlatans.  Orthodox  doctors insisted that all quacks were harmful and that strict medical licensing laws were needed to remove them from the medical marketplace.

Despite being split into many groups that had different ideas about the  nature  of  disease  and  therapy,  irregular  practitioners collectively agreed  that  regular  medicine  was both  ineffective and  dangerous. Of course, not all critics of orthodox medicine  were healers with competing medical theories. For example, Thomas Jefferson (1743–1826) respected

his good  friend  Benjamin  Rush  (1745–1813), but  was quite  sure  that his enthusiasm  for bleeding and  purging  had  been very harmful.  Fol- lowers of the approach epitomized  by Rush  were all too eager to treat victims  of  epidemic  cholera   (a  disease  that   may  cause  death   by dehydration) with ipecac, vomits  of salt and  water,  frequent  doses of calomel, castor oil, and enemas of spirits of turpentine. Although  Rush never lost faith in his therapeutic system, many Americans were attrac- ted to healers  who offered  remedies and  regimens  that  were allegedly safe, natural, and effective.

Some irregulars  were empirics  or specialists—such  as, herbalists,

midwives, dentists,  and  oculists—who  offered  a limited  range  of ser- vices, without  pretensions  to  learned  medical  theories.  Other  healers were members of medical sects or religious sects, such as Seventh Day Adventists and Christian  Scientists. Some leaders of popular  health cru- sades offered  guides to dietetic  regimens  that  would  allegedly obviate the need for all drugs and  doctors.  Unorthodox healers might also be charismatic  individuals,  with or without  medical training,  who claimed to  have  discovered  marvelous  devices or  drugs  that  were being  sup- pressed  by the  dominant medical  profession.  Whatever  their  theories of  health,  disease,  and  therapy,   unorthodox healers  emphasized  the dangers  and  expense of orthodox medicine. Many  novel medical sects arose in the nineteenth  century,  but Thomsonianism, eclecticism, natu- ropathy,  hydropathy, and homeopathy were the best known  and most coherent.  By the end  of the century,  many  of the early medical  sects had essentially disappeared, and homeopathic and eclectic practitioners faced growing competition  from osteopaths and chiropractors, as well as the increasingly unified and powerful regular physicians.

In the 1830s and 1840s, the age of Jacksonian democracy,  popular

opinion favored egalitarianism,  democratic  ideals, and laissez-faire eco- nomics.  The  followers  of Andrew  Jackson  (1767–1845), seventh  pres- ident of the United States, denounced the creation of monopolies, restrictions  on commerce, and all claims of expertise, professional  privi- lege, and authority. In this context,  Americans called into question  the professional  authority and legal monopoly  demanded  by regular physi- cians. As Mark  Twain (1835–1910) explained, Americans  believed that every man should be ‘‘free to choose his own executioner.’’

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