At the close of the eighteenth century in America, medicine and medical authority rested within the Jeffersonian ideal of the natural aristocracy--what Jefferson himself called the "aristoi." The notion was simple: among Americans, there were a select few, produced through good breeding and education, who were fit to lead the nation. Within a profession like medicine, medical authority hinged on the practitioner being first and foremost a gentleman. Though there were professional doctors, a large number of men claimed the title of physician as an aside to their primary profession of politician, minister, or scholar. For these individuals, medicine was more a diversion than a proper science. However, like the republican ideals that created the aristoi, medical authority was increasingly under siege during the first quarter of the nineteenth century. The resulting backlash resulted in a chaotic pastiche of personal healthcare disguised as freedom. It wasn't until after the Civil War, when rules governing health professionals were codified, that the physician regained authority. After the war, authority was gradually established not through class, but via training, guidelines, and licensing. Throughout the century, as leisure reading increased, debates occurred within the popular and professional literature of the time that echoed the sentiments of the people. This project rests on the idea that published literature is an echo of the social discourse and that the readers of that literature knew full-well to what the authors were alluding. Through primary and secondary texts, I uncover the full narrative of the contest for medical authority in the nineteenth century. While medical texts generally support the need for qualified, trained physicians, popular works frequently worry over the consequences of rapid and unchecked expansion, mental health, and gender differences in the way that women are medically treated. The early chapters focus on the republican elite and the concerns of expansion at the end of the eighteenth century. By looking at the work of Benjamin Rush, Thomas Jefferson, and the fiction of Charles Brockden Brown (Edgar Huntly) and Robert Montgomery Bird (Nick of the Woods), I show how there was increased awareness that too rapid national expansion might lead to a breakdown of republican values. Later chapters illuminate the struggle between established and homeopathic medicine as Jacksonian policies emerge and the doctor-as-professional is born. The result is a sharp decline in medical authority and standards for training, revealing the relative chaos brought about by myriad choices for self-treatment. Texts include: Recollections of the Last Ten Years (Flint), Life and Adventures of an Arkansaw Doctor (Rattlehead), Swamp Doctor (Lewis), and A New Home, Who'll Follow? (Kirkland). These are contrasted with works published in the few medical journals in publication and the rise and fall of Thomsonianism and its founder Samuel Thomson. The third chapter examines mental health on the frontier and how individuals react to psychological trauma. Texts include: Hobomok (Child), Hope Leslie (Sedgwick). Medical texts include writings and speeches by Daniel Drake. Finally, I examine the growing cries for medical reform at the dawn of the Civil War. Oliver Wendell Holmes in Elsie Venner exemplifies the evolution of medical science in diagnosis and treatment As a result of the public's growing clamor and the undeniable evidence gleaned from the war experience, medical organizations that granted merit-based licenses were finally widely accepted, reestablishing medical authority.
Read
