The American Dominative Medical System as a Reflection of Social Relations in the Larger Society

This chapter provides a corrective to the paucity of neo-Marxian analyses of medical pluralism by viewing the American medical system as a reflection of class, racial/ethnic, and gender relations in the larger society. It traces the evolution of the American medical system from a relatively pluralistic one in which no single medical system was clearly dominant to a dominative one in which bourgeois medicine achieved dominance over competing systems. The medical systems of complex societies are characterized by pluralism. These systems are hierarchical rather than adjacent in that bourgeois medicine enjoys a dominant status over heterodox and ethno medical practices. The evolution of the American medical system from a relatively pluralistic to a dominative form occurred in the wake of the transition of the American political economy from competitive capitalism to monopoly capitalism. As a professionalized heterodox medical system, homeopathy posed a threat to regular physicians and prompted them to establish the American Medical Association in 1847.