Popular Health Movement
Encyclopedia
The Popular Health Movement of the 1830s–1850s was an aspect of Jacksonian-era politics and society
Jacksonian democracy
Jacksonian democracy is the political movement toward greater democracy for the common man typified by American politician Andrew Jackson and his supporters. Jackson's policies followed the era of Jeffersonian democracy which dominated the previous political era. The Democratic-Republican Party of...

 in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

. The movement promoted a rational skepticism
Scientific skepticism
Scientific skepticism is the practice of questioning the veracity of claims lacking empirical evidence or reproducibility, as part of a methodological norm pursuing "the extension of certified knowledge". For example, Robert K...

 toward claims of medical expertise that were based on personal authority
Authoritarian personality
-Historical Origins:Adorno, Frenkel-Brunswick, Levinson and Sanford compiled a large body of research and theory , which attempted to characterize a personality type that described the “potentially fascistic individual”...

, and encouraged ordinary people to understand the pragmatics of health care. Arising in the spirit of Andrew Jackson
Andrew Jackson
Andrew Jackson was the seventh President of the United States . Based in frontier Tennessee, Jackson was a politician and army general who defeated the Creek Indians at the Battle of Horseshoe Bend , and the British at the Battle of New Orleans...

's anti-elitist views, the movement succeeded in ending almost all government regulation of health care. During the first two decades of the 19th century, states had regularly enacted licensing legislation; by 1845, only three states still licensed medical doctors. Among the leading figures within the movement were Samuel Thompson and Sylvester Graham
Sylvester Graham
The Reverend Sylvester Graham was an American dietary reformer. He was born in Suffield, Connecticut as the 17th child of Reverend John Graham. Sylvester Graham was ordained in 1826 as a Presbyterian minister. He entered Amherst College in 1823 but did not graduate...

.

Principles

Thomsonian medicine, characterized by Paul Starr
Paul Starr
Paul Starr is a Pulitzer Prize-winning professor of sociology and public affairs at Princeton University. He is also the co-editor and co-founder of The American Prospect, a notable liberal magazine which was created in 1990...

 as "a creative misreading of the Enlightenment
Age of Enlightenment
The Age of Enlightenment was an elite cultural movement of intellectuals in 18th century Europe that sought to mobilize the power of reason in order to reform society and advance knowledge. It promoted intellectual interchange and opposed intolerance and abuses in church and state...

," viewed therapeutics within the framework of political ideology. Thompson did not reject science per se, but rather the control of knowledge by an elite who sought to mystify it. One Thomsonian writer asserted, "There can be no good reason for keeping us ignorant of the medicines we are compelled to swallow." In the Thomsonian view knowledge, which in a democracy ought to be available to all, was an element in class conflict
Class conflict
Class conflict is the tension or antagonism which exists in society due to competing socioeconomic interests between people of different classes....

.

Egalitarian politics
Egalitarianism
Egalitarianism is a trend of thought that favors equality of some sort among moral agents, whether persons or animals. Emphasis is placed upon the fact that equality contains the idea of equity of quality...

 was thus a driving force in the Popular Health Movement, as articulated for instance throughout the writings of John C. Gunn:

political equality becomes synonymous with 'equality in knowledge,' and tyranny is fought by the 'equalization of useful intelligence' among American citizens … . Health becomes crucial in these Jacksonian equations because, without health, intelligence, the building block of republican government
Republicanism in the United States
Republicanism is the political value system that has been a major part of American civic thought since the American Revolution. It stresses liberty and inalienable rights as central values, makes the people as a whole sovereign, supports activist government to promote the common good, rejects...

, becomes impaired and feeble. Citizens must be healthy in order to be politically free.


Gunn emphasized an active relationship between physician and patient in the form of dialogue, directed toward understanding sickness in the context of the individual's psychology and everyday habits. Although Gunn was a proponent of common sense
Common sense
Common sense is defined by Merriam-Webster as, "sound and prudent judgment based on a simple perception of the situation or facts." Thus, "common sense" equates to the knowledge and experience which most people already have, or which the person using the term believes that they do or should have...

 and believed that ordinary people could understand practical medicine, his thinking was hierarchical in affirming the authority of professional doctors. Edward Bliss Foote
Edward Bliss Foote
Edward Bliss Foote was an American doctor and author writing about family and social issues and a pioneering advocate in birth control. He was a co-founder of the Free Speech League....

, who was among those arrested under the Comstock law
Comstock Law
The Comstock Act, , enacted March 3, 1873, was a United States federal law which amended the Post Office Act and made it illegal to send any "obscene, lewd, and/or lascivious" materials through the mail, including contraceptive devices and information. In addition to banning contraceptives, this...

s for advocating and selling contraceptive devices
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...

, titled one of his books Medical Common Sense, for which he advocated from the first sentence of the preface:

'Common Sense,' I am aware, is quoted at a discount; especially by the medical profession, which proverbially ignores everything that has not the mixed odor of incomprehensibility and antiquity. Medical works are generally a heterogeneous compound of vague ideas and jaw-breaking words, in which the dead languages are largely employed to treat of living subjects.

Role of women

The Popular Health Movement coincides with a resurgence of women as health practitioners. In colonial America, most medical care had been administered at home by a woman, and the lay practice of medicine was dominated by women. By the Jacksonian era, a male-driven culture of self-proclaimed expertise — licensing was still not the norm — had displaced even midwifery
Midwifery
Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also help care for the newborn and assist the mother with breastfeeding....

 in the care chosen by the upper and middle classes. The decline of women as medical practitioners parallels their withdrawal from other occupations, such as shopkeeping, in which women had freely engaged during the colonial period. But as the population dispersed, particularly in the South and West, a lack of access to physicians contributed to women once again playing a major role in providing health care. Gunn's work Domestic Medicine, for instance, provided detailed instructions on delivering babies; performing vaccinations, abortions, and minor surgeries; and recognizing and treating the symptoms of disease. Because male physicians almost unanimously opposed admitting women into the profession, during the 1830s women involved with healing were more likely to find allies among alternative medical practitioners such as Sylvester Graham
Sylvester Graham
The Reverend Sylvester Graham was an American dietary reformer. He was born in Suffield, Connecticut as the 17th child of Reverend John Graham. Sylvester Graham was ordained in 1826 as a Presbyterian minister. He entered Amherst College in 1823 but did not graduate...

.

Although there were social barriers to professional education for women, the women's rights movement advanced the efforts of women to obtain formal medical training, and in 1848, the New England Medical College in Boston
Boston
Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...

 (now Boston University School of Medicine
Boston University School of Medicine
Boston University School of Medicine is one of the graduate schools of Boston University. Founded in 1848, the medical school holds the unique distinction as the first institution in the world to formally educate female physicians. Originally known as the New England Female Medical College, it was...

) became the first medical school in the world that was exclusively for women.

Consequences

The egalitarian impulse encouraged ordinary people to acquire knowledge, but this informed awareness of what it took to obtain a high level of expertise eventually led to a proliferation of medical schools and licensing — that is, to a greater emphasis on credentials. A "dialectic" between the culture of professionalism and the culture of democracy thus shaped 19th-century medicine in America, which throughout the Western world was a time of progressivity in medical science. The same democratic rationality that had provoked skepticism about medical authority became logically allied with advances in science, which in turn undermined appeals to common sense by establishing methodologies of expertise.
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