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Class 2: Who practiced medicine?

Introduction:

During the antebellum period government oversight of medical practice was minimal, and many different sorts of healers flourished in the United States. Regular medical doctors learned their trade in medical schools and through apprenticeship; some traveled abroad for further training in the hospitals of Paris, Edinburgh, and London. In a reaction against the sometimes harsh therapies of regular medical doctors, a variety of medical sects became popular in the antebellum United States. These included the Thomsonian/herbal practitioners, the homeopaths, and other healers. They challenged the status quo by claiming their remedies were milder and just as effective. Black and white women practiced health care in the home, and in the community as midwives/healers. Nursing was not an organized profession, and there were not schools for nursing education in the United States Because both the Union and Confederate armies required an examination for commission as an army surgeon, the governments imposed uniformity on practice that was at odds with the "caveat emptor" attitude toward medical practice that had prevailed in the decades just prior to it. They turned down most sectarian practitioners, women, and blacks who sought to serve, except as nurses.

Readings:

Fett, Sharla. Working Cures, Healing, Health and Power on Southern Slave Plantations. Chapel Hill: University of North Carolina Press, 2002, 111-141.

Kaufman, Martin. "American Medical Education." In The Education of American Physicians. Edited by Ronald Numbers. Berkeley: University of California Press, 1980, 7-28.

———. "Homeopathy in America." In Other Healers: Unorthodox Medicine in America. Edited by Norman Gevitz. Baltimore: The Johns Hopkins University Press, 1988, 99-123.

Rothstein, William G. "The Botanical Movements and Orthodox Medicine." In Other Healers: Unorthodox Medicine in America. Edited by Norman Gevitz. Baltimore: The Johns Hopkins University Press, 1988, 29-51.

Discussion Questions:

• The era before the Civil War saw a decline in the state governments' regulation of medical practice. Many argued, "let the people choose" not the government. Should the government regulate health care practitioners?
  
  
• How does a war change the answers to question 1? Does it matter that in wartime the government has taken official responsibility for the troops under its command, whereas in peacetime the government has no such responsibility? Does the government have a stronger reason for healing in wartime (get the soldier back to his unit) than it does in peacetime?
  
  
• What factors go into creating a "profession"? In nursing, for example, what is the difference between a woman nursing a family member and a professional nurse? How would she establish her legitimacy as a professional? By what signs would you recognize her as different from any other woman who laid a cool washcloth on the forehead of sick child? Might there be degrees of transition from lay to professional?