This research explores how social actors adjudicate knowledge claims within intellectual environments where epistemic standards are contested. Through the case study of 19th century debates over cholera in the United States, I examine the strategies deployed by orthodox and homeopathic physicians in the struggle over medical knowledge during this "epistemic contest." The 1832 cholera epidemic ushered in a crisis for orthodox medicine, as epistemological standards for adjudicating medical knowledge claims became challenged and ill-defined. Failing to muster an effective cultural response to homeopathy, orthodoxy adopted an organizational strategy, forming the American Medical Association and offering professional membership as a proxy indicator of legitimate knowledge. The AMA created an organizational/intellectual space insulated from homeopathy, which translated into a concerted campaign to exclude homeopaths from government institutions and affected the nature of orthodox knowledge on cholera. This case reveals that epistemic contests are not waged by cultural means only; organizational practices form an integral part of actors' repertoires in adjudicating epistemological claims in practice.