'This list includes the names of those individuals who made significant writing contributions to the report and/or were consistently involved with the report over the many months required to complete it. Many others at the Chantilly, Virginia, workshop also contributed to the initial discussions and development of broad outlines for various chapters. Introduction by Larry Dossey, M.D. and James P. Swyers, M.A. The Constitution of this Republic should make special provision for Medical Freedom as well History of Medicine in the United States M -Benjamin Rush Surgeon General of the Continental Army of the United States edicine in the United States has evolved from an eclectic mix of Native Ameri-can, African, Eastern, and European botanical traditions. In colonial and postcolonial America, there were dozens of competing medical philosophies, each claiming to have the "divine right" to practice medicine. By the early 1800s, medical practitioners included homeopaths, naturopaths, botanics, and Thomsonians. Competition was fierce, and the practice of medicine was essentially wide open (Hogan, 1979). However, in the mid-1800s, the medical system we now refer to as biomedicine1 began to dominate the scene. Biomedicine was shaped by two important sets of observations made in the early 1800s: (1) specific organic entities-bacteria-were responsible for producing particular disease states and characteristic pathological damage; and (2) certain substances-antitoxins and vaccines-could improve an individual's ability to ward off the effects of these and other pathogens. Armed with this knowledge, investigators and clinicians began to conquer a myriad of devastating infectious diseases and to perfect surgical procedures. As their conquests mounted, biomedical scientists came to believe that once they found the offending pathogen, metabolic error, or chemical imbalance, all afflictions-including many mental illnesses-would eventually yield to the appropriate vaccine, antibiotic, or chemical compound (Gordon, 1980). This philosophy eventually led them to extend their purview beyond the bounds of physical and even mental disease to conditions that previously had been viewed in religious, moral, economic, or political terms. For example, births and deaths, which traditionally had taken place at home, were moved to the hospital. During the late 1800s, the American Medical Association (AMA), which was first organized in 1847, sponsored and lobbied for enactment of State licensing laws. By 1900, every State had enacted such a law. The result was a quick decline in competition from other schools of medical practice (Starr, 1982). The ability of biomedicine to eliminate competition was further strengthened with the passage of the Pure Food and Drug Act of 1906 and the first court trial under this act in 1908 (McGinnis, 1991). In 1910, the fate of competing forms of medicine was 'This is the more accurate technical term for the style of medical practice in which practitioners hold either an M.D. (medical doctor) or D.O. (doctor of osteopathy) degree. Other terms for this system include allopathy, Western medicine, regular medicine, conventional medicine, mainstream medicine, and cosmopolitan medicine. All of these terms have some applicability, but none is as accurate as biomedicine. Allopathy, the most specific of these terms, denotes a tendency to choose therapies that oppose symptoms (allo = opposite) and enables parallels with terms such as osteopathy, homeopathy, and naturopathy. The other terms (mainstream, conventional, etc.) are less accurate but are better known and thus will be used throughout this text interchangeably with biomedicine. |