Doctoral Dissertation Research: Medicine, Magic, Mirage: Redefining the Boundaries of Medical Therapies in Modern America

什么是医学研究的科学方法，谁决定什么是科学医学，什么不是科学医学？医学的定义如何影响医学疗法的发展和应用？这些问题构成了科学与社会论文改进拨款调查的基础，该基金将使用NSF的资金在美国的档案馆收集相关数据。界定科学的和非科学的医学方法之间的界限的过程仍然存在激烈的争议。通过改变治疗合法性、可接受性和合法性的参数和定义，包括监管机构、广告商、消费者、专业人士和慈善家在内的各种利益相关者参与了这些边界的形成。这篇论文探讨了制度结构、职业目标、立法改革和消费者需求如何塑造了二十世纪初美国以科学为基础的医学正统的发展。在这方面，论文对现有的医学人文文献做出了重要贡献，该文献提供了一个分析框架，旨在检验关于非正统医学运动如何产生、发展和影响卫生服务提供的假说，但未能综合考察主导医学范式和边缘医学范式之间边界形成过程中涉及的各个利益相关者。本文从广泛的视角出发，以案例研究为框架，阐述了各种利益集团或利益相关者的角色。这些案例研究旨在说明正统和非正统医学之间动态而复杂的关系随着时间的推移，以现有关于科学文化边界的学术工作的方式的历史发展。这种类型的分析包括区分获取、形成和提供可靠和科学的医学知识的有效和无效的方式，同时检查文化可信度是如何以及在哪里确定的。这篇论文对这篇文献以及更广泛的科学研究文献做出了贡献，通过确定和说明通过定义科学在每个领域中的作用来促进健康和医学的多重和有争议的意义所使用的技术。这份手稿还将对科学史和医学史等更广泛的学科做出至少两项额外的重大贡献。首先，通过确定正统和非正统医学疗法之间的历史边界，它将解释立法、经济、哲学和专业动态的联系如何参与定义和传播什么是医学科学。其次，通过将这些发展放在其社会和文化背景下，论文将评估决定治疗地位的因素，不仅讨论它们与科学的关系，而且讨论它们与对健康和生活的价值观、信仰和哲学取向的关系。由于非正统的治疗系统通常被定义为偏离科学知识、支持非传统的形而上学系统以及对经验传统的承诺，将替代和主流医疗系统和治疗之间的对话记录在案，有助于重新定义每一种系统和治疗的当代社会和医学影响，同时提供对医学和社会的更广泛理解。这项研究将使论文得以完成，促进在学术期刊上发表草稿文章，并为最终的书稿提供基础。研究人员使用在线出版物的经验以及与现场档案保管员的工作讨论也允许更广泛地传播研究成果。这项拟议的研究还代表着一项史无前例的努力，即广泛纳入来自私人和专业组织的未发表的档案材料，展示了在20世纪初为界定科学医学的界限所做的广泛努力。

What constitutes a scientific approach to medical inquiry and who determines what is scientific medicine and what is not? How does the definition of medical science influence the development and application of medical therapies? These questions form the basis for inquiry in the Science and Society Dissertation Improvement Grant, which will use NSF funding to collect relevant data at U.S. based archives. The process of defining boundaries between scientific and unscientific approaches to medicine remains highly contested. A variety of stakeholders have been involved in forming these boundaries including regulators, advertisers, consumers, professionals, and philanthropists by altering the parameters of and definitions for therapeutic legitimacy, acceptability, and legality. The dissertation explores how institutional structures, professional objectives, legislative reforms, and consumer demand shaped the development of a scientifically based medical orthodoxy in the early twentieth century United States. In doing so, the dissertation makes a crucial contribution to existing literature in the medical humanities which provides an analytical framework designed to test hypotheses about how unorthodox medical movements arise, develop, and affect the delivery of health services but fails to synthetically examine various stakeholders involved in the process of boundary formation between the dominant and peripheral medical paradigms. Drawing from a broad range of perspectives, the dissertation is framed by case studies illustrating the roles of various interest groups or stakeholders. These case studies are designed to illustrate the historical development of the dynamic and complex relationships between orthodox and unorthodox medicine over time, in the fashion of existing scholarly work on the cultural boundaries of science. This type of analysis involves distinguishing between effective and ineffective ways of acquiring, formulating, and providing reliable and scientific medical knowledge while examining how and where cultural credibility is determined. The dissertation contributes to this literature, and the broader literature in science studies, by identifying and illustrating the techniques used in promoting multiple and contested meanings of health and medicine, by defining the role of science in each area. The manuscript will also make at least two additional major contributions to the broader disciplines of the history of science and the history of medicine. First, by identifying the historical boundaries between orthodox and unorthodox medical therapies, it will explain how a nexus of legislative, economic, philosophical, and professional dynamics were involved in defining and disseminating what constitutes medical science. Second, by placing these developments in their social and cultural contexts, the dissertation will assess the factors that determine the status of therapies by discussing their relationship not only to science but also to values, beliefs, and philosophical orientations toward health and life. Because unorthodox therapeutic systems have often been defined by their deviation from scientific knowledge, support of unconventional metaphysical systems, and commitment to the empirical tradition, historicizing the dialogue between alternative and mainstream medical systems and treatments facilitates redefining the contemporary social and medical influence of each while providing a broader understanding of medicine and society. This research will allow for the completion of the dissertation, facilitate the publication of drafted articles in scholarly journals, and provide the basis for an eventual book manuscript. The researcher's experience with online publications and working discussions with on-site archivists also allow for additional broad dissemination of research findings. The proposed research also represents an unprecedented effort to broadly incorporate unpublished archival material from private and professional organizations, demonstrating the breadth of efforts to define the boundaries of scientific medicine in the early twentieth century.