Introduction

IntroductionAt the dawn of the nineteenth cen ury, Western medicine sailed a precarious course between the lamentations of doubters and the siren calls of apostates. The structure of the human body-organs, nerves, bones, and muscles-had been determined with some degree of certainty, but the institutes of medicine and materia medica appeared to many as a confusion of “principles, conjectures, arguments, and testimony from a . . . thousand conflicting sources.”1 While the claim seemed inordinately rhetorical, it was no more or less than what many held to be true. As one of the century’s more trenchant critics explained, medicine survived as “the shameless wreck of numerous exploded systems.”2 So much so that together doubters and apostates accused medicine of presenting a façade of authority that only incompletely hid centuries of error. Medical orthodoxy was not orthodox or monolithic at all, but a successive number of competing systems. Disregarding opposing doctrines, most systems offered patients a monotonous and repetitive fare of bloodletting, purging, puking, sweating, and blistering. The success of any one system of medicine elicited few marks of respect, fewer still of gratitude.