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.’’