Knowledge in the Time of Cholera (57 page)

Descartes, René,
16

de Tocqueville, Alexis,
58
,
62

diagnosis: of cholera,
31
,
32
,
41
,
90
,
168
,
169
; and laboratory analysis,
184
,
189
,
194
,
195
,
209
,
239
; and patient/doctor relationship,
195
,
219

Dickens, Charles,
33
,
75

diffusion model, of epistemology,
5–6
,
152

diphtheria,
7
,
24
,
176
,
180
,
239

discovery: allopathic/regular physicians' narrative of emergent discovery,
165–67
,
171
,
177
,
178
,
179
,
181
,
225–26
; attribution model of,
154
,
155–58
,
178
; and construction of narratives,
157
; and epistemic authority,
153
,
155–56
; and germ theory,
156
,
158
; homeopaths' narrative of prediscovery,
162–65
,
170
,
225–26
; and network formation,
156–57
,
171
,
263n3
; process of,
151–58
; transformation of Koch's research into,
153–58
,
166
,
171
,
178
,
179
,
182

dot maps,
115
,
118–19
,
119
,
121–23
,
225
,
263n4

economic development, cholera linked with,
76

education reform: and alternative medical movements,
216
,
217
; and American Medical Association,
80
,
95
,
103–4
,
205
,
207
,
216
; and consolidation of medical authority,
28
,
52
,
179
,
219
,
257n3
; and epistemological change,
203
; and German-American network,
172–73
; and homeopathy,
55
,
98
,
101
,
103–4
,
214
,
216
; and hospitals,
204
,
209
; and laboratory analysis,
194
,
203–8
,
210
,
211
,
216
,
223
,
245
; and medical epistemology,
203
; and Paris School,
83–85
,
88
; and public health,
212
; standards of,
203–4
,
205
,
206–7
,
208
,
219
,
223
,
245
,
264n5
; and Thomsonism,
54
,
55
,
79
; and Welch,
204–5

Egypt,
148
,
149
,
166
,
167

Ehrlich, Paul,
170
,
239

elective affinity,
63–65
,
261–62n10

Eliot, Charles,
203

empiricism: and allopathic/regular physicians,
40
,
42
,
43
,
47
,
84
,
85
,
88
,
170–71
,
190
; and bacteriological paradigm,
192
,
193
; bedside empiricism,
44
,
80
,
84
,
86
,
87
,
165
,
181
,
189
,
192
,
193
,
209
,
218
,
223
; and cholera epidemic,
77
; and diagnosis,
184
; and germ theory,
160
; and homeopathy,
56
,
79
,
87
; proto-empiricism,
44–45
,
47
,
83
.
See also
radical empiricism

Enlightenment,
85

environmental illness,
252

epidemiological data,
160

episteme,
11
,
252

epistemic authority: claims of,
27
,
191
; as cultural product,
81–82
; and discovery,
153
,
155–56
; and epistemic contests,
18
,
19
,
21
,
113
,
136
,
146
,
177
,
183
,
191
,
249
,
259n15
; and ethos,
18
,
114–15
,
116
,
127
,
146–47
; framing of,
112–16
,
194
; as grounded in content,
114
–15
; as grounded in methodology,
114–15
; and laboratory analysis,
183–84
,
190
,
191
,
194
,
196
,
219
,
220
; and professionalization,
146
,
185
; and sanitary movement,
113
,
114
,
126
,
128
,
146
,
183

epistemic closure: and American Medical Association,
108
,
238
,
246
; and epistemic contests,
20
,
27
,
181
,
213–17
,
238
,
249
,
251
; insularity of,
246
; and laboratory analysis,
214
,
217
,
218
,
238–39
; and meaning of disease,
224
; and medical reform,
208–17
,
219
,
246
; process of,
217
,
231
,
242
; shaping of modern medical profession,
22
,
28

epistemic contests: and allopathic/regular physicians,
26–27
,
39
,
67
,
70
,
85
,
94
,
96
,
98
,
106
,
107
,
108
,
113
,
153
,
156
,
158
,
161
,
243
; and alternative medical movements,
21
,
22
,
26
,
37–39
,
48
,
49
,
59
,
70
,
71–72
,
73
,
80
,
85
,
224
,
227
,
230
,
235
,
243
; and analogical theorizing,
253
; and boards of health,
112–14
,
115
,
135
,
146
,
147
,
189
; and cholera epidemics,
22–23
,
26
,
59
,
73
,
78
,
79–80
,
217
,
224
; and competing actors,
19–20
,
28–29
; and competing epistemological systems,
18
; concept of,
231–32
,
248–51
; conditions of,
19
,
228
,
251–53
; contexts of,
233
,
250
; distinctiveness of,
17
,
249
; diversity of,
249
; and embedded strategic action,
233
,
249–50
; and epistemological change,
16
,
21
,
229
,
233
,
249
,
258n7
; and expert knowledge,
190
; and homeopathy,
26
,
38
,
59
,
67
,
71
,
78
,
79
,
85
,
93
,
94
,
98
,
100
,
107
,
113
,
153
,
156
,
158
,
161
,
179
,
180
,
181
,
213–17
,
224
; and institutional arenas,
38
,
59
,
113
,
249
; and interaction between actors,
21
,
71
,
233
; and Koch's findings,
151
,
153
,
156
,
158
,
161
,
180
; legacy of,
237
,
238
; and legitimate knowledge,
17
,
18
,
20
,
38
,
81
,
107
,
259n15
,
260n16
; and medical professionalization,
226–33
,
238
; and motivations,
28–29
; and organizational factors,
18
,
20
,
27
,
38
,
80
,
81–83
,
106–8
,
188
,
191
,
213–14
,
225
,
232–33
,
250
; and power disparities,
20
,
30
; and radical empiricism,
85–87
; role of discoveries in,
27–28
; and single case study method,
250–51
,
259n14
; source materials on,
254–56
; and Thomsonism,
38
,
59
,
67
,
71
,
78
,
224

epistemological change: and alternative medical movements,
234–35
; and education reform,
203
; and epistemic contests,
16
,
21
,
229
,
233
,
249
,
258n7
; and medical professionalization,
4
,
5
,
9
,
10
,
11
,
13
,
221
,
227
,
229
; politics of,
13
; and shifting standards,
247

epistemological styles,
248

epistemology: assumptions about standards of truth,
9–10
,
11
,
12
,
232
,
247
,
258n7
; collective agreement on,
10
; debates on,
13
,
15–21
,
247
,
258n7
; democratic view of,
62
,
63
,
243
; empirical analysis of,
248
; and feminist critiques,
259n11
; historical epistemology,
247
; and justification of knowledge,
15–16
,
18
,
42
; and legitimate knowledge,
18
,
38
; linear progress of,
9–10
; and philosophy,
16
,
259n12
; and power inequalities,
245–46
; social epistemology,
244
,
258n6
; sociology of,
9
,
12–13
,
14
,
16
,
245–53
,
258n6
; and sociology of scientific knowledge,
15
,
259n10
; temporal directionality of,
11–12
,
155
; as universal,
153
.
See also
medical epistemology

ethnicity,
188
,
264n1

ethos, and epistemic authority,
18
,
114–15
,
116
,
127
,
146–47

Europe: cholera in,
31–33
,
148
,
183
,
260n1
; medical sciences in,
160
; statistical techniques of,
58

evidence-based medicine (EBM),
252

evolution debates,
253
,
266n10

Ewald, Paul,
25

expert knowledge: in democratic cultures,
26–30
,
146
,
190
,
219–20
,
242–46
; and medical epistemology,
218
,
219
; and medical professionalization,
191
,
227
; performance of,
14
; and pragmatism,
190
; and private philanthropy,
200
; and professions,
190
,
227
,
228
,
243
; and scientific expertise,
8
,
190
,
192–94
,
198
,
200
,
203
,
219
,
226
,
234
,
258n5

Fenton, Reuben,
111
,
133

fermentation theories,
92
,
159

Ferran, Jaime,
183
,
184
,
265n6

fibromyalgia,
252

Flexner, Abraham,
200
,
206–10
,
211
,
214
,
216
,
219–20
,
223

Flexner, Simon,
202
,
206

Flexner Report,
205–7
,
208
,
209
,
223
,
234
,
245
,
264n6

Flint, Austin,
89

Flower, Roswell,
187–88

Foucault, Michel,
11

Fourcade,
Marion,
265n4

France,
32
,
148
,
150
,
151
,
156
,
230–31
.
See also
Paris School of medicine

Frasch, Herman,
199

Freidson, Eliot,
14
,
219
,
257n3

Fuller, Steve,
218–19
,
258n6

Galileo,
252–53

Gates, Frederick T.,
200–203
,
207–8
,
214