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Soc Sci Med. 2004 Feb;58(4):703-12.

Schism and heresy in the development of orthodox medicine: the threat to medical hegemony.

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  • 1Department of Sociology, Faculty of Social Sciences and Health Care, Queen Margaret University College, Edinburgh EH12 8TS, UK.


Medical and scientific knowledge is not intrinsically different from other kinds of knowledge and has gone through the same processes in terms of its development. As a profession, medicine achieved its dominance in the 19th century and has subsequently consolidated its power base. A socio-historical perspective shows us that medicine has no more and no less fraud, heresy, schism, and relative knowledge than any other equivalent forms of knowledge. Orthodox medicine emerged from a number of healing systems in the 19th century by claiming the superiority and consequent authority of the biomedical model and its special relationship to laboratory science. This process has been seen by some to resemble the growth of religious orthodoxy and the emergence of alternative beliefs with the dissenting medical systems, based on different paradigms, becoming analogous to religious sects. An increasing body of opinion rejects the notion of "objective" knowledge and sees medical knowledge and practice as "socially constructed". An examination of HIV/AIDS measurement and 19th century craniology and contagion and anti-contagion theories indicates processes which are "contextual" rather than "objective". Heresy and schism are natural concomitants of socially constructed knowledge, functioning as providers of impetus and change and, as such, are to be welcomed as non-orthodox challenges.

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