interpreted the âdiscoveryâ of the comma bacillus of Robert Koch in 1884. Drawing on an âattributional modelâ of discoveries, this chapter explores the role of âdiscoveriesâ in epistemic contests, showing how the project to configure Kochâs research into a discovery involved both cultural and organizational dimensions. Both homeopaths and allopathic physicians initially staked a claim to Kochâs research, attempting to frame this research into a discovery that justified their respective systems of medicine through different discovery narratives. I show how allopaths offered a more effective discovery narrative, which facilitated the construction of a network linked to German science and allowed them to claim Koch as their own to the detriment of homeopathy.
The final empirical chapter discusses the consolidation of allopathic professional authority and elimination of sectarian threats. Allopathic reformers sought epistemic closure through an epistemology of the laboratory, based on the germ theory of disease 22 and the laboratory sciences imported from Germany (Bonner 1963). This approach redefined cholera as a microorganism, identified in the lab through the microscope, and treatable through vaccines, antitoxins, and inoculations. Despite this reframing, laboratory analysis was routinely ignored during the 1892 cholera scare. Cognizant of government skepticism and the limitations of achieving professional recognition through public health, the AMA adopted a conscious program to circumvent government institutions by aligning itself with private philanthropies. Reformers found allies among industrial philanthropists who were beginning to integrate the laboratory into their businesses and eventually convinced them to fund their program of scientific medicine. Using these philanthropic resources, allopathic reformers were able to make the laboratory the âobligatory passage pointâ (Latour 1987, 132) for all medical knowledge, to create an organizational infrastructure around the lab under their control and purified of homeopathic influence, and achieve the standardization of medical education along bacteriological lines. Epistemic closure was achieved by allopaths without having to debate the merits of their system in the democratic public institutions where they had been continuously defeated.
While it is difficult to reconstruct the motivations of actors long dead, especially since the issue of motivation is best approached on an individual case-by-case basis, Iâd be remiss not to say something about how I conceive of the actors in this book. These physicians should not be reduced to cynical political operatives. Nor should they be romanticized as disinterested seekers of truth. Between these two extremes lies a more balanced depiction of actors with multiple (often conflicting) motivations. The shifting commitments to particular epistemological systems by nineteenth-century physi cians were driven both by a desire to solve intellectual problems and a desire to gain a strategic advantage in the epistemic contest. Physicians, whatever their sectarian allegiance, strove to make sense of cholera while also gaining recognition and power. It is this messy combination of noble truth-seeking and base politicking that makes epistemic contests so compelling.
The particularities, and peculiarities, of the professionalization of U.S. medicine facilitated the rise of an exceptional medical system, unusual in the developed world. Although a comparative analysis of the organization of medicine in different countries is beyond the scope of this project, suffice it to say that the U.S. medical system is widely viewed as an odd duck. The twin pillars of this exceptionalismâits embrace of private interests and its wholesale adoption of a scientific vision of medicineâoriginated from the particular trajectory of the epistemic contest that resulted in a profession highly suspicious
The final empirical chapter discusses the consolidation of allopathic professional authority and elimination of sectarian threats. Allopathic reformers sought epistemic closure through an epistemology of the laboratory, based on the germ theory of disease 22 and the laboratory sciences imported from Germany (Bonner 1963). This approach redefined cholera as a microorganism, identified in the lab through the microscope, and treatable through vaccines, antitoxins, and inoculations. Despite this reframing, laboratory analysis was routinely ignored during the 1892 cholera scare. Cognizant of government skepticism and the limitations of achieving professional recognition through public health, the AMA adopted a conscious program to circumvent government institutions by aligning itself with private philanthropies. Reformers found allies among industrial philanthropists who were beginning to integrate the laboratory into their businesses and eventually convinced them to fund their program of scientific medicine. Using these philanthropic resources, allopathic reformers were able to make the laboratory the âobligatory passage pointâ (Latour 1987, 132) for all medical knowledge, to create an organizational infrastructure around the lab under their control and purified of homeopathic influence, and achieve the standardization of medical education along bacteriological lines. Epistemic closure was achieved by allopaths without having to debate the merits of their system in the democratic public institutions where they had been continuously defeated.
While it is difficult to reconstruct the motivations of actors long dead, especially since the issue of motivation is best approached on an individual case-by-case basis, Iâd be remiss not to say something about how I conceive of the actors in this book. These physicians should not be reduced to cynical political operatives. Nor should they be romanticized as disinterested seekers of truth. Between these two extremes lies a more balanced depiction of actors with multiple (often conflicting) motivations. The shifting commitments to particular epistemological systems by nineteenth-century physi cians were driven both by a desire to solve intellectual problems and a desire to gain a strategic advantage in the epistemic contest. Physicians, whatever their sectarian allegiance, strove to make sense of cholera while also gaining recognition and power. It is this messy combination of noble truth-seeking and base politicking that makes epistemic contests so compelling.
The particularities, and peculiarities, of the professionalization of U.S. medicine facilitated the rise of an exceptional medical system, unusual in the developed world. Although a comparative analysis of the organization of medicine in different countries is beyond the scope of this project, suffice it to say that the U.S. medical system is widely viewed as an odd duck. The twin pillars of this exceptionalismâits embrace of private interests and its wholesale adoption of a scientific vision of medicineâoriginated from the particular trajectory of the epistemic contest that resulted in a profession highly suspicious
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