A LESSON IN HISTORIOGRAPHICAL AND METHODOLOGICAL TRENDS

Medical History

WHAT IS THE PURPOSE OF MEDICAL HISTORY?

The past gives us important perspective on the present

The past can be used as an activist tool

The past displays the rich professional heritage of physicians

The past is a vehicle for helping medical students make sense of the professional culture they are entering

“ [W]HEN IT COMES TO PUBLIC HEALTH, THE SOCIETY HAS A RIGHT TO INSIST THAT THE

COMMUNITY’S INTERESTS COME BEFORE THE SHAREHOLDERS’ PROFITS. IT IS NOT ENOUGH FOR INDUSTRY TO TOUT THE BENEFITS OF ITS PRODUCTS; IT MUST ALSO INFORM PEOPLE OF

THEIR POTENTIAL DANGERS. THIS IS NOT A RADICAL PROPOSAL”

Gerald Markowitz and David Rosner, Deceit and Denial, page 305.

WHAT IS THE HISTORY OF THE HISTORY?

The Physician as Medical Historian

Medical History Before 1800

History played a central role in physician training

Medical students were well-versed in Greek, Latin, logic, rhetoric, and philology

medical history used to defend medical decision-making, to weigh the pros and cons of various therapeutic practices in the past, and also for developing or remolding or rearranging medical theories so that they fit the contemporary needs of medical doctors

Medical history had the potential to instill a sense of civic responsibility

Definition:

Philology is an older term for linguistics, and especially for the branch of linguistic study devoted to comparative and historical research into the development of languages. In a wider sense, the term sometimes also covers the study of literary texts. A researcher in this scholarly field is a philologist.

•THE CRITIQUE OF HISTORICAL PATHOLOGY

•GROWING FAITH IN PROGRESS THROUGH EXPERIMENTAL SCIENCE

•THE LABORATORY REPLACES THE LIBRARY AS THE CENTRAL INSTITUTION WHERE MEDICAL KNOWLEDGE IS LEARNED AND PRODUCED

The Rise of Scientific Medicine and the Decline of Medical History, 1850-1890

The Leipzig Institute

The Challenge to Scientific Medicine in North America

William Osler, 1849-1919

A Canadian physician

Trained at the University of Toronto and later McGill, where he received his medical degree in 1872

Joined the medical staff of Hopkins in 1889

The role of history in the “Oslerian Method”

Prolific writer, focus mainly on Great Doctors and other inspirational stories in medical history

The German School is Transplanted to North American

Henry Sigerist (1891-1957) – arrives in U.S. 1932, joins Johns Hopkins as the head of the Institute of the History of Medicine

Owsei Temkin (1902-2002) – arrives at Johns Hopkins in 1932 with Sigerist

Ludwig Edelstein (1902-1965) – arrives in 1934

Sigerist Biography

Did more than anyone else to establish, promote, and popularize history of medicine

Head of the Institute of the History of Medicine at Hopkins from 1932-1947

An “articulate apostle of socialized medicine”Believed in the importance of teaching the history

of medicine to doctorsEstablished the Bulletin of the History of MedicineBook, Socialized Medicine in the Soviet Union

created a huge sensationLeft U.S. In 1947; died in Switzerland in 1957

Sigerist, on the Soviet Union:

“I love the country. I love its socialism but I also love the people and the landscape, so much that I would have liked it even under Tsarism.”

“Our students are still trained to be primarily interested in disease and not in health,” he wrote. “Most people do not see a doctor unless they are sick. Russia is far from having reached its goal, but the idea to supervise man medically from the moment of conception to the moment of death and to concentrate all efforts on prevention of disease is undoubtedly very promising and impresses me as the beginning of a new era in medicine.”

ENTER THE NON-PHYSICIAN HISTORIANS OF MEDICINE

Charles Rosenberg

Charles Rosenberg

• trained over 50 doctoral dissertations throughout his career

•The Cholera Years (1962) – set example for how historians of medicine should take a broader view and examine not just a disease and its victims, but society’s response to it through politics, laws and social mores

•Trained by both an academic historian and a physician-historian

•RACE•CLASS•GENDER•ETHNICITY•SEXUALITY

HISTORIANS WERE INSPIRED BY THEORIES OF MARX, FEMINISM, AND LATER ON, POST-STRUCTURALISM.

The Expansion of Historical Inquiry after the 1970s

1. FEMINIST MOVEMENT2. CIVIL RIGHTS MOVEMENT3. ANTI-WAR MOVEMENT4. STUDENT MOVEMENT5. BLACK PANTHERS/BLACK POWER

Social Movements Shape Historical Writing

Emily K. Abel, "Family Caregiving in the Nineteenth Century: Emily Hawley Gillespie and Sarah Gillespie, 1858-1888," Bulletin of the History of Medicine, Vol. 68, No. 4 (Winter 1994): 573-599.

•She asks, “what were women doing to care for the sick and dying in the nineteenth century?”

•Diaries as a way of getting at women’s experiences, from their perspectives

•Thesis: “women’s responsibilities for care not only disrupted their lives but also enabled them to acquire extensive medical knowledge and skills, brought them into sustained contact with fundamental aspects of human existence and bound them to a broader network of friends and kin.”

•Women mattered…often more than male physicians