Doctoral Dissertation Research: Cholera and Quacks: The Struggle Over 19th-Century Medical Knowledge

这项科学、技术与社会博士论文研究改进助学金旨在探索19世纪美国霍乱的科学发展及其与医学职业化的关系。在此期间，正统医学经历了职业权威的深刻转变。尽管另类医疗团体在19世纪中期成功地挑战了许多机构的正统，但在世纪之交，正统医生重新定义了他们在细菌学下的专业知识，创造了一个强大的、自主的职业。这个项目试图回答正统医生是如何在细菌学范式下巩固他们在19世纪初失去的专业权威的。该论文项目将霍乱作为一场“认知竞赛”的案例研究，在这场竞赛中，具有相互竞争的范式的集体参与者在不同的机构中为获得认可而斗争。在这场认识竞赛中，关乎的不仅仅是霍乱知识，还有科学医学的定义(即如何以及由谁获得合法的医学知识)。通过研究相关机构和医疗团体的档案记录，该项目追踪霍乱概念的变化，以便：1)重建认识竞赛的演变，2)阐明不同医学派别所宣传的认识论，3)检查用于促进这些认识立场的文化战略的有效性。它假设，正统医学在公共机构中被击败，是因为另类医学派别的透明认识论在这些公共机构中产生了更好的共鸣。常客们只是通过将辩论与公众监督隔离开来，说服一小群精英(即洛克菲勒和卡内基基金会)支持他们在政府机构之外的专业项目，才实现了对霍乱定义的控制。这项研究通过系统地研究超科学论战的作用，挑战了传统的知识扩散模型。通过引入认知竞赛的概念，本研究探索了疾病的科学知识是如何在公共机构内获得、验证和合法化的。

This Science, Technology & Society Doctoral Dissertation Research Improvement Grant seeks to explore the scientific development of cholera and its relationship to the professionalization of medicine in the nineteenth century United States. During this period, orthodox medicine experienced a profound shift in professional authority. Although alternative medical groups successfully challenged orthodoxy in a number of institutions during the mid-1800s, at the turn of the century, orthodox physicians redefined their expertise under bacteriology, creating a powerful, autonomous profession. This project seeks to answer how orthodox physicians were able to consolidate their professional authority, which had been lost in the early 1800s, under the bacteriological paradigm. The dissertation project examines cholera as a case study of an "epistemic contest" where collective actors with competing paradigms struggle for recognition in various institutions. More than knowledge on cholera, at stake in this epistemic contest was the definition scientific medicine (i.e. how and by whom legitimate medical knowledge should be attained). Through a study of archival records from relevant institutions and medical groups, the project traces shifting conceptions of cholera in order to: 1) reconstruct the evolution of the epistemic contest, 2) elucidate the epistemologies propagated by different medical sects, and 3) examine the efficacy of the cultural strategies used to promote these epistemic positions. It hypothesizes that orthodox medicine was defeated in public institutions because the transparent epistemologies of alternative medical sects resonated better with these public institutions. Regulars only achieved control over the definition of cholera by insulating the debate from public scrutiny, convincing a small group of elites (i.e. the Rockefeller and Carnegie Foundations) to support their professional project outside of government institutions. This research challenges traditional diffusion models of knowledge by systematically investigating the role of extra-scientific polemics. By introducing the concept of the epistemic contest, this research explores how scientific knowledge of disease is obtained, verified, and legitimated within public institutions.