Biomedicine and Alternative Healing Systems in America: Issues of Class, Race, Ethnicity, and Gender (review)

Hans A. Baer. Biomedicine and Alternative Healing Syste ms in America: Issues of Class, Race, Ethnicity, and Gender. Madison: University of Wisconsin Press, 2001. xii + 222 pp. Tables. $55.00 (cloth, 0-299-16690-2), $21.95 (paperbound, 0-299-16694-5).

This look into the relationship between organized biomedicine and the nation's competing alternative medical systems is coupled with some very obvious political overtones that point ultimately to the demand for a universal health-care system "that incorporates alternative therapies and that treats health care as a right rather than a privilege" (p. 189). In reaching this conclusion, Baer has brought together nearly twenty years of interdisciplinary research on class, racial/ethnic, and gender issues. Beginning with such early-nineteenth-century groups as the botanics, Thomsonians, and eclectics, and moving into the century's later physiomedicals, homeopaths, hydropaths, osteopaths, chiropractors, Christian Scientists, folk healers, and other marginal medical groups, he traces the story of regular medicine and the challenges it faced from heterodox medical systems.

While Baer explains the relationship between biomedicine and alternative medical systems in the dialectical terms of "annihilation, restriction, absorption, and even collaboration" (p. 5), he also points out the limited power of organized biomedicine and the growing accommodation to the processes of legitimization that occur among certain alternative practitioners. In explaining this process, however, he wields a heavy ideological hand that defines America's transition to scientific medicine as a corporate decision of American capitalism "to neglect the social origins of disease while at the same time, in at least some instances, restoring workers back to a level of functional health essential to capital accumulation" (p. 4). Ultimately, he argues for a holistic health system that reaches across class, gender, and racial/ethnic minorities, and that, through a "prolonged process of struggle," will ultimately replace capitalism at the national level with a "global system of democratic eco-socialism" (p. 189).

Baer is at his best when he analyzes the metaphysical and religious components of heterodox systems of medicine, many of which were based on a form of vitalism. He also handles well the decline of heroic medicine in the first half of the nineteenth century; the early challengers to regular medicine, principally from homeopathy; the influence of Grahamism, hydropathy, Seventh-Day Adventism, and spiritualism on the health-reform movement; and the post-Civil War challenges of Christian Science, osteopathy, and chiropractic. He describes how, among the heterodox medical systems of the early nineteenth century, homeopathy and eclecticism came increasingly to resemble regular medicine. At the same time, he explains the transformation of regular medicine into biomedicine, and the advantages it used to overshadow its competitors.

More controversial is Baer's ratiocination for regular medicine's transformation into scientific medicine, which he attributes to a collusion of elite practitioners, medical researchers, and the industrial capitalist class "to establish political, economic, and ideological dominance over rival medical systems" (p. 31). To accomplish this objective, he explains, regular medicine joined with corporate-sponsored foundations to ameliorate class conflict by focusing on specific cures for specific diseases, thereby deflecting attention away from the social origins of disease. Biomedicine's dominance in the twentieth century, he argues, depended upon an alliance between the American Medical Association and the state, an alliance that resulted in various controls over medical heterodoxy, including codes and consultation clauses, medical examining boards, rigorous licensing standards, and accreditation. Although Baer argues that the process was not necessarily the product of a conscious shaping of social thinking, it is hard for the reader to conclude otherwise. The factors that the author lays out for the transformation of American medicine from a predominantly pluralistic structure to one dominated by a reductionist scientific class suggest a more conspiratorial basis.

Baer does a good job of describing the various medical systems and their corresponding status within what he...