During the development of medicine in nineteenth century
Britain and the United States, the 'regular' profession was
faced with severe competition from 'unorthodox' practitioners.
Most significant amongst these were the professional homeopaths.
They were just as ~ell educated and qualified as the
regulars, and so they posed the deepest threat to their continued
plausibility as the source of all that was 'Good', 'True'
and 'Scientific' in professional medicine. The cognitive
anxiety which professional homeopathy raised was further
intensified by the fact that recruitment to the ranks of homeopathy
was made from the regular profession itself. Many converts
to homeopathy were prepared to pay the professional and personal
costs of being labelled a 'quack' for the sake of their own
integrity and the apparently more effective therapeutic
certainties of homeopathy. They were prepared to abandon the
systems of regular medicine, be they heroic, sceptical, neovigorous
or eclectic, in order to be at peace with their own
conscience, and to practice a system of medicine they were now
convinced was far more effective than any form of regular therapy.
During this period, regular medicine passed through three basic
styles of theory and practice. These were the Heroic-Bedside,
Clinical-Hospital and Bacteriological-Laboratory Medical
Cosmologies. Particularly during the Heroic and Clinical phases,
the regulars developed an anti-homeopathic ideology which they
deployed in the various conflicts which ensued. I ts purpose
was to define the homeopaths as 'deviants' and medical
'heretics'. The regulars did this by the use of a 'vocabulary
of insult' which stigmatized their opponents. By further
employing the tactics of intolerance and social control they
were able to secure their own claims to political and 'scientific'
legitimacy. However, the supposedly 'rational' and
'scientific' refutations of homeopathy by many eminent regular
practitioners (such as Oliver Wendell Holmes and James Young
Simpson) were actually constructed at a time when the therapeutic,
pharmacodynamic and aetiological knowledge of regular medicine
was immature and highly uncertain.
I shall argue that the claimed refutation of homeopathy during
the 1830's to 1860's was not, indeed could not be, accomplished
on scientifically 'objective' grounds (i.e. on the grounds of
intersubjectively testable, empirical and experimentally
reproduceable knowledge). Therefore, its actual grounds were
those of conventional professional social norms, practices
and traditions. The defence of regular medicine by means of an
anti-homeopathic, anti-quack ideology and the rhetorical claim
to 'scientificity' was a sign of an insecure and crisis-ridden
profession. It was dangerous for regulars to admit, both
professionally and personally, the therapeutic efficacy of
homeopathy claimed by its adherents. For the majority of the
regulars, the cost - emotional, cognitive and social – would be too high. In these terms (rather than mere professional
duplicity) we can explain the attempted suppression of the
statistical returns of the London Homoeopathic Hospital,
which showed the success of their treatments, from the
official report on the 1853/54 cholera epidemic.
A mature scientific therapeutics began to develop with the
emergence of the bacteriological research programme, based upon
the work of Robert Koch. He was able to provide a secure
experimental, methodological and ontological basis for the
germ theory of disease causation. However, its therapeutic
fruitfulness was not realised in practice (for people that is)
until the 1890's, with the mass manufacture of diphtheria
anti-toxin based upon the research of Emil von Behring.
Therefore, the known development of medicine, and especially of
therapeutics, does not support the claim by the regulars during
the nineteenth century (and after) that homeopathy was refuted
by unambiguous experimental, clinical and 'scientific' means.
The actual means to do that did not emerge upon the historical
scene until 1876 at the earliest (with Koch's bacteriological
work) and with fuller effect not until the 1890's. However, by
that time the conflict between regular and homeopathic practitioners
was no longer of any interest to the centres producing
standardized scientific knowledge; the bacteriological laboratories
of university-hospitals, the proprietary drug industry, and
various government and private research institutes. The
'refutations' of homeopathy developed a half-century earlier, were taken to be sufficient warrant to continue to (a) reject
homeopathy cognitively, if not legislatively,- and (b) refuse
it the courtesy of agreed experimental test when the actual
means to do so were then available.
Therefore, within the asymmetries of power, structures of
domination and mechanisms of social control developed by the
regulars in their pursuit of 'scientific' legitimacy,
occupational closure and market monopolisation, the homeopaths
were marginalized. However, they were not completely powerless
against the regulars. They were able to obtain some important
compromises and concessions from them, even if what was gained
in America turned out to be far more temporary compared to the
moral and legislative achievements of their less numerous
British counterparts. The medical historians standard model to explain the 'success'
of 'scientific' regular medicine and the 'failure' of
'unscientific' homeopathic medicine, as the result of the
progressive, linear, accumulation of 'facts' is no longer
adequate to the task. This is because of the model's/historian's
assumptions that the ideological evaluations already performed
in relation to those it has stigmatized as 'unscientific'
and (or because) 'unorthodox', during the nineteenth century,
were (and are) epistemologically 'True' and l:npolluted by
political/ideological interest. It is the purpose of this work
to demonstrate that such a science/ideology polarity is unable to adequately explain the historical rejection of homeopathy
throughout the century and to propose a conception of monopoly,
marginality, power and ideology which is adequate to that
task.