History Of Medicine

For Many Approaches, Styles, and Aims

Xavier Bosch

Histories of medicine have thoroughly examined the development of medical theories and the treatment of diseases in Western culture. Less known are how different countries and cultures have approached their medical heritages and to what degree accounts of their medical histories have been influenced by social, cultural, and philosophical issues. Such investigation of the history of medical historiography is the main purpose of Locating Medical History: The Stories and Their Meanings, a collection of 20 essays developed from an international conference held in Maastricht, The Netherlands, in June 1999. The contributors largely concentrate on how the field of medical history established itself during the 19th and 20th centuries. Some chapters include discussions of such major personalities as Karl Sudhoff (the founding director of the first institute in medical history, at Leipzig) and Henry Sigerist (Sudhoff's successor, who later left Germany for Johns Hopkins, where he worked to professionalize the field of the history of medicine as well as to influence contemporary health policy). The volume also deepens to encompass examinations of the trend for medical histories to adapt social perspectives and the polarization between physicians interested in the development of medicine and Ph.D.'s interested in the social or cultural history of medicine.

Over the last two decades, medical history has thus become increasingly interesting to scholars with backgrounds in history rather than medicine. This development has facilitated the linking of the history of medicine to wider historical concerns, from politics to attitudes about gender within society to popular beliefs about health and the body. It has led to the publication of numerous specialized studies influenced by the new social history. Not surprisingly, some modern historians criticize standard books about the history of medicine on the grounds that these often pluck medicine out of its social and historical context and thus distort rather than explain the past.

The reviewer is in the Department of Internal Medicine, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain. E-mail: [email protected]

Locating Medical History

The Stories and Their Meanings Frank Huisman and John Harley Warner, Eds.

Johns Hopkins University Press, Baltimore, MD, 2004. 519 pp. $45, £32. ISBN 0-8018-7861-6.

The volume opens with an overview of histories of medicine by the editors, medical historians Frank Huisman (Maastricht University) and John Harley Warner (Yale University). This introduction challenges currently common descriptions of "'traditional' medical history." Chapters in the first of the book's three major sections, "Traditions," examine the history of the field during the 19th and early 20th centuries.

The middle section, "A Generation Reviewed," explores how the history of medicine came to be approached more as a social enterprise than as a purely scientific or celebratory one. In their essay " 'Beyond the Great Doctors' Revisited," Susan Reverby and David Rosner point out that "as more and more of us entered the field in the late 1970s from the periphery, the center of gravity shifted away from traditional centers of research such as Johns Hopkins, the home of. ..the Institute of the History of Medicine, and spread more widely throughout the historical landscape."

To address such questions as how the professionalization of medical history has been reflected in changes in its literature and whether the discipline has moved closer to general social and cultural history, Olga Amsterdamska and Anja Hiddinga examined articles published between 1960 and 2001 in the four major history-of-medicine journals. Tracking trends in the citations in and of these articles, they conclude that medical history today is being written by historians rather than physicians and that the attention of its scholars has shifted "from heroic tales about individual physicians.. .to more.. .con-textualized stories of professionalization and the everyday practice of medicine." They argue that professionalization "has taken a long time" and that shifts in topics are better described as a process of diversification than as a dramatic refocusing of attention. Contrary to their expectations, they also found that the audience for medical history is mainly physicians and medical researchers: A third of the citations to the five most highly cited papers from each journal for 1988 to 2000 were from medical journals such as JAMA and The Lancet. The citations in these journals were slightly more numerous than those in

Detail from Diego Rivera's The History of Cardiology (1943-44). A fresco painted for the Instituto Nacional de Cardiologia, Mexico City.

journals of medical history and much more numerous than those in general historical journals.

"After the Cultural Turn," the volume's third section, "plunges into the methodological and political swamp of practices and controversies." As a clinician, I found particularly useful Jacalyn Duffin's chapter "A Hippocratic Triangle." Duffin, a clinician-historian, was asked by the editors to consider "history written and read by clinicians.. .and how it could be used in teaching." She argues that an M.D. degree is not a predictor for subject, method, or style and that there are only the individual fascinations of individual historians that enlighten other people. In contrast to historians' claims that teaching history to medical students is a waste of time because future doctors will never become real historians, she explains that teaching history to medical students "will make them better doctors.. History draws attention to organized reasoning. Learning a second language always enhances understanding of the first. I see no reason to skimp on content or on scholarship. All doctors will become historians of their own patients."

Locating Medical History more than succeeds as, in the editors' words, "an invitation to explore and reflect on a 'field'— one that can include widely disparate senses of what medical history is, should be, and should do." The volume contains several specialized and deeply theoretical essays intended for the medical historian, but any physician or researcher interested in the current status of the history of medicine will also enjoy and learn from it.

10.1126/science.1107232

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