Shaping the medical market: on the construction of quackery and folk medicine in Dutch historiography

Abstract

It has been stated many times: traditionally, medical history was written by, for and about doctors, telling the story of unilinear scientific progress. Positivism tended to look at the history of medicine as a process of linear progress from religion through metaphysics to science, in which mankind was liberated from superstition and irrationality. This view was confirmed by the Weberian notion of a "disenchantment" of the world: in the course of the last few centuries, the influence of magic and animism was seen as having declined. In the field of medical thinking and medical practice, man was thought to have freed himself from the chains of superstition. Gradually, he had learned to relate to the world in rational terms; in the event of illness, academic doctors were the logical engineers of his body. However, the times of the grand stories are over, in general as well as in medical history. With non-physicians moving into the field, there has been a growing awareness of the constructed nature of medicine.1 Medical knowledge has come to be seen as functioning within a specific cultural context from which it derives its meaning.2 Today, illness is no longer considered to be a universal, ontological unit. Instead, the meaning of illness-as well as the response to it-is thought to be determined by factors of a social, economic, political and religious nature.3The attraction of the old historical image lay in its simplicity. However, it is highly problematic to characterize developments in the field of health care in terms of a

The appeal of medical quackery: A rhetorical analysis

“…Health care has been compared to a "medical market," where all practitioners "bid" for the trust of their patients. 2 This establishes an ethos attack that sets up modern medicine as a conniving profit center, with the friendlier, seemingly straightforward, natural approach of alternative medicine standing in stark contrast. 2…”

“…22 This stems in part from the historical shift from looking at the history of medicine as a linear progression of accumulating knowledge, with illness as an ontological unit and the physician as an educator, toward illness being determined by multiple factors: social, economic, political, and religious. 2 The traditional medical view sets up a patriarchal and hierarchal system where the patient is passive and reliant upon the doctor for treatment to the point of "addiction" to their dictates. 22 Alternative rhetoric argues that this reliance on orders creates a natural tension, like Eve being told not to eat the "apple" in the garden, and ultimately modern doctors "'hex' the healing process because of their incredulity in the human body's capacity to maintain wellness."…”

“…1 In fact, as reported by Huisman, the founders of the Dutch Society Against Quackery first wrote a book in the late 1800's aiming to combat quackery by analyzing the techniques charlatans used to sell their remedies. 2 Like in the past, assessing the advertising of today's pseudo-medicine can provide an understanding of what makes those seeking alternative medicine susceptible to dubious medical claims. This understanding can provide health care practitioners with new ways to address misleading health care claims with their patients.…”

Panacéias disseminadas pela Internet e pacientes vulneráveis: como conter um mercado de ilusões?

“…Mais recentemente, uma pesquisa na base de dados PubMed revelou artigos que denunciam essas fraudes há mais de meio século (27). Em 1993, quando a Internet ainda era mal conhecida fora dos meios acadêmicos, o conselho holandês de saúde divulgou um relatório sobre o uso de métodos de cura alternativos (26), concluindo que, mesmo ao final do século XX, a "cura pela fé" envolvia um crescente mercado de ilusões, tanto em número de consumidores como em variedade de produtos.…”

Medicine, media and the public

“…Furthermore, as the advertisement above suggests, not only 'professional' physicians made use of a medical discourse to bolster their credibility. 4 In fact, studies have shown that experts of all kinds, ranging from academics to natural healers, mothers or priests, were dependent on their audiences for recognition of their authority. 5 To sum up, static divides -between the scientific and the popular sphere, between the expert and the lay public, and between orthodox and heterodox medicine -were nuanced by a more multifaceted interpretation of knowledge production, ascribing a more active role to historical actors outside of the academic world.…”