Academic journal article Journal of Social History

Revisiting Maverick Medical Sects: The Role of Identity in Comparing Homeopaths and Chiropractics

Academic journal article Journal of Social History

Revisiting Maverick Medical Sects: The Role of Identity in Comparing Homeopaths and Chiropractics

Article excerpt

The development of American medicine is of particular relevance to social historians as a window into and reflection of 18th and 19th century American social and cultural history; it is also commonly taken as an illustration of the professionalization processes. (1) Within this framework, the case of medical sectarianism, defined as practioners who developed outside the venue of the mainstream American Medical Association, has demonstrated, among other things, the tension between the extraordinary variance in medical practice, and the evolving political hegemony of a once fledgling medical association. Yet, underlying the many well-developed studies of sectarian groups such as the homeopaths, chiropractics, eclectics, water therapists, Christian scientists, and osteopaths, to name the strongest, certain tenets of conventional wisdom have dominated. These include the well-accepted notion that 'regular' and established medicine prevailed largely due to the preponderance of an increasingly accepted scientific medical model; the capability of regular physicians to dominate resources and institutionalizing mechanisms, such as schools, journals and hospitals; and an overall medical paradigm that increasingly won social support and professional legitimacy. (2) While condensed here, the reigning historical model explaining the dominance of regular physicians can be summed as a survival of the fittest theory in resource acquisition, institutional growth and affirmed paradigm.

Some portions of the standard medical history model are irrefutable, such as the fact that mainstream medicine DID develop a more acceptable paradigm aligned with the scientific mindset of the day; its practitioners DID organize into an effective and vocal political majority (at least after fifty years of struggle); and its methods and outcomes did win social support as well as institutionalizing superiority in the advent of thousands of hospitals which emerged between 1880-1920, and the growing array of established medical schools.

Nevertheless, a key piece of the puzzle is left out, and it explicitly involves social history. As we look toward the evolution of sectarians in Europe, the outcomes differ dramatically from those of the United States during the period. While distinctive government response to sectarian medicine explains part of the differences, this too is not the whole picture. Against the survival of the fittest approach, this essay applies a theory germane to organization theorists known as identity theory, and how it factors in the success or demise of two sectarian groups. It argues that while the role of external control, political and cultural support, resources and a dominant paradigm were influential in the fates of the largest of the medical sectarian groups--the chiropractics and homeopaths, the role of identity also played a causal role in the differing outcomes. The dynamic of identity is used to augment, not displace standard social and medical history arguments as an additional, distinct thread in the survival of chiropractic and the demise of American homeopathy. Here, we outline the internal identity struggle, drawing on the minutes of meetings, reports, records and discussions among the members of both schools. This internal identity struggle is juxtaposed with the more quantitative records of resources and institutionalizing mechanisms. (3)

The Medical Sectarians

We define medical sectarians as groups of physicians who were not part of the American Medical Association, but who were organized with ideologies and distinctive institutionalizing mechanisms. Sectarian denotes a position external to the mainstream, legitimated organization, as in religious sectarians, and provides a good lens through which to view identity formation, against a comparative backdrop.

At the turn of this century, tens of thousands of sectarian physicians were organized into societies of practitioners; by conservative estimates between 1 in 3 to 1 in 4 of medical doctors were sectarians. …

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