Guenter B Risse | University of California, San Francisco (original) (raw)

Books by Guenter B Risse

Clio Medica, 1987

This paper examines in chronological order four seminal venues of academic teaching during the 18... more This paper examines in chronological order four seminal venues of academic teaching during the 18th century in Europe. These activities reflected the need for training larger numbers of health professionals who wished to implement the Enlightenment's ideas on health preservation and recovery among all sectors of the population. in fact, these early "proto clinics" proved to be invaluable models for the organization of a new "hands on" approach that decisively contributed to Europe's burgeoning medicalization.

ABSTRACT. This 1971 Ph.D. thesis was submitted to the History Department at the University of Chi... more ABSTRACT. This 1971 Ph.D. thesis was submitted to the History Department at the University of Chicago. It is primarily the story of medical theory and practice in Germany during the decade 1796-1806. In this short but eventful period, the Brownian (Brunonian) system of medicine played a central role in the efforts of German physicians to make the healing art more rational and predictable. In fact, with the assistance of philosophy, this strong desire to promote medical certainty dominated all contemporary systematic efforts. The dissertation first examines the state of German medical theory between 1770- 1790 before describing the life and work of John Brown (1736-1788). A third chapter deals with the transmission of Brownianism to continental Europe and its reception in Germany. The search for a philosophical science of medicine between 1796-1800 follows. A final chapter highlights this quest with a focus on “Naturphilosophie,” notably the conceptions of Friedrich W. I. Schelling and the subsequent decline of Brown’s system between 1801 and 1806.

Filling a significant gap in contemporary scholarship, this book looks at the past to offer criti... more Filling a significant gap in contemporary scholarship, this book looks at the past to offer critical lessons for our age of bioterror threats and emerging infectious diseases. Public health history requires an understanding of irrational as well as rational motives. To that end delving into the spectrum of emotions that drove extreme measures like segregation and isolation is essential. These feelings fed psychological, ideological, and pragmatic urges to scapegoat and stereotype victims—particularly nineteenth-century immigrants victims-of smallpox, leprosy, plague, and syphilis isolated in San Francisco’s Pesthouse. This forgotten institution arose within a climate dominated by widespread public dread and disgust. Emotional states like xenophobia and racism played an important role. Yet the phenomenon also included competing medical paradigms and unique economic needs that encouraged authorities to protect the city's reputation as a haven of health restoration. Ultimately, the story offers valuable comparisons with American reactions to AIDS, SARS, and more recently Ebola fever

By probing public health interventions in the setting of one of the most visible ethnic communiti... more By probing public health interventions in the setting of one of the most visible ethnic communities in United States history, this work offers insight into the clash of Eastern and Western cultures in a time of medical emergency.

The book explores a wide range of social and medical issues, exposing the contradictions and ambi... more The book explores a wide range of social and medical issues, exposing the contradictions and ambiguities found in eighteenth-century Scottish health, science and medicine. Separate essays tell a wide range of stories, from aspects of local health and disease to medical institutions as well as theory and practice.

The book furnishes a unique insight into the world of meanings and emotions associated with hospi... more The book furnishes a unique insight into the world of meanings and emotions associated with hospital life by including narratives from both patients and caregivers. The story is told in a dozen episodes which illustrate the transformation of hospitals from houses of mercy to tools of confinement, from dwellings of rehabilitation to spaces of clinical teaching and research, from rooms for birthing and dying to institutions of science and technology. From ancient Greece to the era of AIDS, the book features key hospitals , covering the most important themes in the development of medicine and therapeutics.

Proceedings of a conference organized in 1989 by the AIDS History group sponsored by the American... more Proceedings of a conference organized in 1989 by the AIDS History group sponsored by the American Association for the History of Medicine to evaluate the literature on AIDS and discuss ways for applying historical standards to that information. Four workshops examined epidemics before AIDS, responses from clinical and biomedical research as well as society and plans for documenting AIDS history.

Histories of hospitals have traditionally failed to probe the actual nature, routines, and meanin... more Histories of hospitals have traditionally failed to probe the actual nature, routines, and meaning of institutional confinement. Patients and their diseases usually remain on the periphery while actual medical interventions are simply omitted or judged to be harmful. By contrast, this work offers the first complete account of the actual nature, routines, and meaning of institutional life in an eighteenth-century British hospital. The first voluntary establishment of its kind founded outside of London, the Royal Infirmary of Edinburgh is examined within the context of the Scottish Enlightenment as well as the tenets of British philanthropy. From its inception, this hospital was the focal point for the convergence of charitable intentions, civic pride, and the improvement of medicine.
Using a multitude of surviving documents, including hospital registers, ward ledgers, lecture notes, patient records and medical publications, the author presents an intimate view of the experiences of Scotland's sick poor and the appointed physicians between 1770 and 1800. Nearly a thousand individual clinical histories were sampled and subjected to a computer analysis that not only revealed the spectrum of diseases selected for treatment but also the outcomes of the medical intervention. The book effectively demonstrates that through careful patient selection and basic support, the infirmary was far from being a "gateway to death" institution, playing instead a benevolent and educational role that placed it among the top hospitals of the eighteenth century.

This ground-breaking publication places the history of homeopathy into its international context.... more This ground-breaking publication places the history of homeopathy into its international context. Essays by leading scholars re-examine homeopathy's status as an alternative medical system with particular attention to the shifting fortunes of Hahnemann's medicine within national networks of professionals and lay persons.

Exploration of self healing and American domestic medical practices based on a series of contribu... more Exploration of self healing and American domestic medical practices based on a series of contributions presented at a 1975 symposium at the University of Wisconsin, Madison. The tradition of self-help in medicine has existed since time immemorial. Until healing roles were clearly defined and professionalization was on its way, much of what constituted healing was fundamentally domestic in nature. In fact, it could be argued that healing was originally a familial or communal activity before being ritualized and invested in special persons. The essays, develop a number of themes. The decision to focus on the American scene—especially the last 150 years—is, of course arbitrary. The choice was primarily prompted by the availability of sources and the existence of a nucleus of prominent social historians interested in the topic. Medical self-help continues to be an essential practice and resource, and its history should be subjected to critical examination.

Proceedings of a symposium held at the University of Wisconsin in April 1972 dedicated to the fir... more Proceedings of a symposium held at the University of Wisconsin in April 1972 dedicated to the first critical analysis of recent developments in medical techniques and public health in the People's Republic of China.

Updated version of the original 1953 survey stressing developments in physiology since the 19th c... more Updated version of the original 1953 survey stressing developments in physiology since the 19th century. This study illuminates the importance of schools, groups of researchers and their disciples in the evolution of the field with major attention devoted to developments in Germany.

Papers by Guenter B Risse

Programs of the large research foundations imply the hope that by such endowments new facts and n... more Programs of the large research foundations imply the hope that by such endowments new facts and new points of view fundamentally important in medicine may be discovered. Many of these establishments serve in a way to mediate between the problems of practice and the findings of science."(1912) 1

ABSTRACT Translating biological knowledge from the laboratory to the bedside as well as collectin... more ABSTRACT
Translating biological knowledge from the laboratory to the bedside
as well as collecting clinical data to stimulate further bench research remain at the core of Western medicine’s advances. This inquiry probes the historical evolution of clinical investigation in hospitals employing a multilevel framework that highlights the overlapping boundaries of space, social structure, professional status, scientific knowledge, human values, and moral sensitivity. Using the example of New York’s Rockefeller Research Institute and Hospital during the early 1900s, the essay explores how conditions necessary for conducting bedside studies were negotiated and implemented. The creation of a new clinical research mission, training of physician/scientists, as well as the establishment of a novel patient/researcher relationship laid the foundations for modern American biomedicine

Clio Medica, 1987

Gut Reactions: Fear and Disgust in Public Health History, 2016

Following the Gold Rush, many Asian migrants arriving in California became afflicted with a host ... more Following the Gold Rush, many Asian migrants arriving in California became afflicted with a host of new and old diseases identified as being hideous or "loathsome," among them smallpox, advanced syphilis, leprosy, and plague. This essay not only observes the appearance of such diseases in the 1870s, but also looks for their relationship with race, lifestyle, and health employing powerful negative emotions that shaped contemporary public health ideas and practices.

American Journal of Hospice and Palliative Medicine, 2012

Social forces have continually framed how hospitals perceive their role in care of the dying. Hos... more Social forces have continually framed how hospitals perceive their role in care of the dying. Hospitals were originally conceived as places of hospitality and spiritual care, but by the 18th century illness was an opponent, conquered through science. Medicalization transformed hospitals to places of physical cure and scientific prowess. Death was an institutional liability. Equipped with new technologies, increased public demand, and the establishment of Medicare in 1965, modern hospitals became the most likely place for Americans to die—increasing after the 1940s and spiking in the 1990s. Medicare’s 1983 hospice benefit began to reverse this trend. Palliative care has more recently proliferated, suggesting an institutional shift of alignment with traditional functions of care toward those facing death.

Journal of the History of Medicine and Allied Sciences, 1974

Clinical Teaching, Past and Present, 1989

ABSTRACT This paper successively examines in chronological order four seminal venues of academic ... more ABSTRACT This paper successively examines in chronological order four seminal venues of academic clinical teaching during the 18th century: Leyden, Edinburgh, Vienna, and Pavia. These activities reflected the need for training larger number of health professionals to implement the Enlightenment’s ideas concerning health preservation and recovery among all sectors of the population. Leyden’s original model using inmates from a nearby hostel for rounds and demonstrations revealed the importance of bedside observation and discussion to bolster practical skills. Attracting large numbers of local and foreign students, Edinburgh, Vienna and Pavia firmly integrated such practical studies into their curricula. Unlike larger metropolitan medical centers in London and Paris with vast hospital facilities and patients suffering from a broad panorama of diseases, the early “proto clinics” proved to be invaluable models for the organization of a “hands-on” approach that decisively contributed to Europe’s burgeoning medicalization.

Bulletin of the History of Medicine, 2006

ABSTRACT Bulletin of the History of Medicine 80.2 (2006) 369-371 Writing one&amp;#39;s da... more ABSTRACT Bulletin of the History of Medicine 80.2 (2006) 369-371 Writing one&amp;#39;s day-to-day experiences has become a popular literary genre, displaying the variety and richness of human life. Sharing information today through blogs or online diaries contributes to our understanding of events and personalities. This anonymous journal, written by a British medical student, highlights his impressions about the academic year before graduation that he spent in Paris between 1 November 1834 and 30 June 1835. The author, enrolled at the University of Edinburgh, was among many foreigners eager to supplement their studies in what was then unquestionably the mecca of Western medicine. The text offers a valuable window into the workings of the renowned Paris Medical School. The unfiltered daily entries reveal a highly motivated and curious medical student determined to make the most of his limited sojourn in the City of Lights. Frugal, searching for cheap lodgings and meals, eschewing a busy social life, he comes across as an extremely focused individual busily shuttling between teaching hospitals from early morning to evening—including Sundays—to witness clinical rounds, surgical procedures, and autopsies. Interspersed between his hastily written observations are brief expressions of ambiguity about French culture and religion. As time wore on, the student&amp;#39;s mood grew hostile; he seemed to perceive that every Frenchman took delight in taking advantage of &amp;quot;raw&amp;quot; Englishmen. &amp;quot;This beastly Paris,&amp;quot; he commented on Christmas 1834, &amp;quot;I detest it more and more everyday of my life&amp;quot; (p. 91). What is missing from the diary, however, are thoughtful reflections about his experiences. Time, of course, was of the essence, &amp;quot;interesting&amp;quot; patients the goal. The diary is full of passing comments about seeing &amp;quot;capital cases,&amp;quot; &amp;quot;absolutely nothing of any consequence,&amp;quot; &amp;quot;can&amp;#39;t say I much benefited.&amp;quot; The Parisian hospitals and clinics were, of course, veritable museums of pathology, with human specimens drawn from the poorer sectors of a metropolis suffering from numerous &amp;quot;fevers,&amp;quot; prominently including tuberculosis, typhoid fever, and syphilis. There are also glimpses of practical skills that this British student definitely wanted to learn. In addition to &amp;quot;walking&amp;quot; the wards, he enrolled in special evening sessions conducted by midwives on the use of the vaginal speculum and forceps, and a private course on diagnosis through the use of the stethoscope and percussion hammer. The downside of a medical education in Paris can be inferred from vivid comments about the large number of students crowding the hospital wards, lecture rooms, and autopsy tables. Rounds by medical luminaries, who were in charge of many patients, could be very speedy and perfunctory, with magisterial comments muffled by the distance from the selected inmate and drowned out by the usual hustle and bustle prevailing in the ample wards. Lecture rooms to witness surgery or case presentations filled up quickly, with eager students even seeking seats during prior, less popular lectures in order to prevent having to hover outside the doorways. Moreover, the diarist was uncomfortable with the dehumanizing approach to French patients, specifically commenting on famous surgeons—cruel &amp;quot;slashers&amp;quot;—who were more interested in developing their techniques than concerned with the welfare of their charges. However, the diary remains silent about the two major criticisms made by other foreign visitors. The first is the almost total passivity of a Parisian education except for the house staff, the appointed &amp;quot;élèves internes&amp;quot;: foreign students observed too much but personally did very little. The sensory overload with &amp;quot;capital&amp;quot; cases was often ephemeral and unstructured, and proved dehumanizing. Finally, while a year spent in Paris could have definitely enhanced professional prestige, how much did it actually matter for subsequent private practice in an English town? The observed clinical spectrum assembled in Parisian hospitals reflected the risks and ecology of disease typical of a great European metropolis. It is doubtful whether the British diarist—tentatively identified as James Surrage of Clifton—would have encountered and managed many of these ailments and...

Essays in the History of Therapeutics, 1991

Journal of Medicine and Philosophy, 1976

ABSTRACT The purpose of this paper is to present a historical example of close interaction betwee... more ABSTRACT The purpose of this paper is to present a historical example of close interaction between medicine and philosophy. The analysis attempts to uncover some of the intellectual and social factors unique to early 19th century Central Europe. Indeed, Germany’s medicine, closely associated with idealist philosophical concepts, was labeled “romantic,” often a pejorative term since its practitioners sought to systematically reorganize and explain healing through precise armchair speculation rather than contradictory bedside observations and analysis. Inspired by ideas from philosophers such as Kant, Fichte, and especially Schelling, physicians attempted to construct a “pure science” of medicine based on universal principles obtained through introspection. This approach was attractive in a politically fragmented but intellectually active country with an extensive and distinguished university system creating a surplus of educated men. Moreover, Germany lacked extensive clinical facilities for the investigation of human diseases. Practitioners were forced to focus on causality, the relationship between theory and practice, as well as the limitations of empirical knowledge. The paper concludes by proposing that the philosophical search for a “science” based on a priori natural laws and principles of organic life, while unsuccessful, laid the groundwork for Germany’s notable achievement in biomedicine decades later.

Clio medica (Amsterdam, Netherlands), 1973

Transactions & studies of the College of Physicians of Philadelphia, 1992

ABSTRACT Public health regulations often elicit strong resistance from the very people they were ... more ABSTRACT Public health regulations often elicit strong resistance from the very people they were designed to protect. Recent responses to AIDS reveal a number of issues concerning authority, power and control, stimulating the examination of historical examples to enhance our understanding. This essay chronicles and analyzes events surrounding the 1916 outbreak of polio in the village and township of Oyster Bay, NY that culminated in a little publicized citizens’ revolt against sanitary and isolation measures. The battle pitted wealthy local landowners—including former US President Theodore Roosevelt—against poorer residents, mostly Italian and Polish immigrants widely blamed for the outbreak.

Bulletin of the history of medicine, 1992

Bulletin of the history of medicine, 1979

ABSTRACT The historical influence of health and disease on healing efforts has long been the back... more ABSTRACT The historical influence of health and disease on healing efforts has long been the backbone of medical history. Yet analyzing possible links between particular conditions and medical ideas and practices continues to be neglected, in part because of historians’ preferences for social and cultural issues and their lack of understanding about the evolving biomedical and epidemiological knowledge. Indeed, advances in the basic sciences promise a plethora of new information useful for clarifying the evolution, spread and impact of selected diseases. Physicians must understand the dynamic character of such shifts and their implications for the profession. The paper argues for a more prominent inclusion of disease studies as a context for medical history. Examples of possible connections between sickness, medical theories and practices are cited, including the impact of 18th century “low” and “putrid” fevers, cholera, typhoid and yellow fever. Such associations help clarify how past societies coped with the problem of acute and chronic illness through the establishment of explanations, healing roles, and therapeutic methods. New patters of disease will undoubtedly have a profound effect on future medical thought and practice.

Bulletin of the history of medicine, 1979

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El Día médico, Jan 7, 1961

The Ohio State medical journal, 1964

Publication - American Institute of the History of Pharmacy, 1997

ABSTRACT Therapeutics is primarily a social process imbedded within temporal and cultural context... more ABSTRACT Therapeutics is primarily a social process imbedded within temporal and cultural contexts in accordance with shifting notions regarding the nature and behavior of the human body and mind. This paper sketches successive historical transformations in therapeutic rationale beginning with an overview of classical Graeco-Roman humoralism. Positing a holistic notion of the body as a cooking vessel capable of boiling and blending fluids, therapeutic interventions sought to assist or duplicate natural healing efforts designed to eliminate potential poisons and restore balance through vomiting, diarrhea and bleeding. By the seventeenth and eighteenth centuries, humoralism was recast in mechanical and chemical terms, leading to new approaches and drug treatments. Subsequent developments during the nineteenth century beginning with French skepticism and the employment of statistics to determine efficacy, all undermined the traditional holistic approaches. They paved the way for a new scientifically constructed therapeutic rationale that required specifically targeted agents, notably the much-vaunted “magic bullets” designed to neutralize the true causes of certain diseases.

Veröffentlichungen der Internationalen Gesellschaft für Geschichte der Pharmazie e. V, 1984

ABSTRACT Renewed attention is bestowed on medicinal plants, especially those growing is isolated ... more ABSTRACT Renewed attention is bestowed on medicinal plants, especially those growing is isolated areas of the globe. Products from China, India, Mexico and Brazil are systematically collected and subjected to pharmacological analysis for possible use. Since each healing system operates within specific socio-cultural contexts, all drugs possess their own explanatory rationale. New remedies, therefore, to be successful, must be recast and placed within frameworks compatible with modern biomedicine. This essay reconstructs some of the circumstances surrounding the transmission of certain American medicinal plants for use in Europe during the first century of discovery and colonization. The story begins with plant collection efforts during Columbus’ expeditions and ends with the voyage of Fernando Hernandez in 1570. With few notable exceptions—the guaiacum tree bark employed in the treatment of syphilis—New World medicinal plants found limited acceptance in Europe. Often their best qualities and therapeutic indications were simply ignored or discarded. The reason: inability to be included within prevailing disease and drug knowledge linked to Galenic physiology and pharmacology. Just as important, Spaniards eschewed the use of “sacred” plants originally employed within a magico-religious milieu for fear of ecclesiastical persecution.

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Gaceta médica de México, 1982

Bulletin of the history of medicine

ABSTRACT Towards the end of the 18th century, European medicine entered a period of great theoret... more ABSTRACT Towards the end of the 18th century, European medicine entered a period of great theoretical uncertainty. System after system crumbled under the weight of new physiological discoveries and clinical insights. This essay offers a comparative analysis of Brunonianism based on the ideas of the Scottish physician John Brown (1735-88) and the emerging French empirical medicine led by Philippe Pinel (1745-1826) and Pierre J. G. Cabanis (1757-1808). Although initially supported by a number of French practitioners and military surgeons, Brown’s dogmatic and sweeping assertions clashed with the clinically oriented leadership of the Paris Medical School, bound to follow their bedside observations of large hospital populations suffering from a wide spectrum of diseases. Eschewing theoretical certainty, French medicine was spared the long period of sterile theoretical discussions that engulfed German and Italian physicians. The clashes illustrate a decisive shift in approach critical for the development of modern medicine.

Mending Bodies, Saving Souls: A History of Hospitals , 1999

Another aspect of Christian hospitality linked to the care of the sick were Europe’s Benedictine ... more Another aspect of Christian hospitality linked to the care of the sick were Europe’s Benedictine monasteries. This chapter illuminates these activities, retelling a contemporary account describing an accident that occurred around the year 968 involving the ruling abbot of the St Gall monastery, a famous Benedictine institution near Lake Constance. For better context, the incident allows for a brief history of this prominent establishment and Benedict’s successful monastic movement before focusing on the spectrum of caregiving efforts centered on its infirmaries and hostels. Details regarding the communitarian and medical approaches follow, including the important role played by St. Gall’s infirmarius in managing the spiritual, medical and surgical aspects of the injury afflicting its abbot. A final comment on the eclipse of monastic medicine stresses the growing rise of lay medicine.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

A chronicle recounting an epidemic outbreak in southwestern Anatolia that afflicted Edessa... more A chronicle recounting an epidemic outbreak in southwestern Anatolia that afflicted Edessa in the year 499 serves as a backdrop for explaining the evolution of a Christian approach to care and healing. Swollen by migrants escaping famine, this ancient population center was quite vulnerable to the spread of infectious diseases. The narrative explains the process of creating a Christian mission of mercy through adoptions of ancient Egyptian and Jewish models of social welfare, making the care of sick people a key component of the Church’s sponsored good works. A section is devoted to the rise of hostels-- xenodocheia or xenones—established to shelter and feed the poor, wanderers or guests, sick and disabled seeking assistance. Prominent bishop- sponsored institutions in Cappadocia and Caesarea, staffed by clergy and secular physicians practicing classical Greco Roman medicine, represent the forerunners of the Western hospital.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

Based on an 11th century eyewitness account, this chapter reconstructs a pilgrimage to Jerusalem,... more Based on an 11th century eyewitness account, this chapter reconstructs a pilgrimage to Jerusalem, focusing on the fate of a German pilgrim whose illness may have been treated at the Holy City’s Hospital of St. John. The narrative offers a brief overview of the perilous journey across the Mediterranean Sea, followed by the travelers’ debilitating land trek through Syria to their ultimate destination. Other sections discuss the Jerusalem hospice’s mission and patronage, especially the feudal imperative to care for “the sick, our lords,” and how the St. John’s Hospital became a model for Christian care around the medieval world.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

Written by a prominent 11th century poet, a personal account of his illness provides a fascinatin... more Written by a prominent 11th century poet, a personal account of his illness provides a fascinating window into the state of health and medicine in the Byzantine Empire. Most importantly, the story not only sheds light on Post-Justinian Constantinople and its lay physicians, but more importantly also brings into focus efforts to create charitable institutions for the care of the sick. The chapter examines both Islamic and Christian establishments before turning towards Constantinople’s imperial hospital foundation: the Pantocrator. Based on the eyewitness account, a final section describes hospital life, treatments, and the ultimate outcome of his sufferings.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

Featuring the Royal Infirmary of Edinburgh, this chapter chronicles the institutional trajectory ... more Featuring the Royal Infirmary of Edinburgh, this chapter chronicles the institutional trajectory of a young female servant seemingly battling a febrile chest cold who had been sent to this establishment by her employer, a subscribing patron. The narrative first examines the qualifications and rituals of hospital admission, nature of her “fever contagion,” and destination, the official teaching ward. Background analysis regarding the role of the Infirmary in Enlightenment Scotland follows, together with details of its most prominent attending physician, William Cullen. Based on his medical theories and practices, management and favorable outcome of the patient’s illness are presented in great detail as recorded in contemporary student notebooks. A final section reviews the method as well as stresses the importance of clinical instruction and research at the Infirmary, an important component of education at the local university, then one of the most celebrated centers of medical learning in the world.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

The story of a modest tailor living in Vienna at the end of the eighteenth century allows for a d... more The story of a modest tailor living in Vienna at the end of the eighteenth century allows for a detailed analysis of contemporary medical research, practice, and teaching. Living alone and seemingly battling the flu, the patient had sought admission to the Allgemeines Krankenhaus, then one of the most prominent hospitals in Enlightenment Europe. To provide the necessary context, a brief history of this imperial foundation follows, together with its architectural characteristics and organization. The narrative then focuses on the institution’s director, Johan Peter Frank, the renown pioneer of Austria’ public health system and also a prominent defender of Brunonianism, a medical system then fashionable in Germany and northern Italy. A subsequent section depicts the application of John Brown’s ideas for patient management in sharp contrast from traditional therapeutics approaches then in vogue. A final segment is devoted to a critical shift in medical pedagogy: the growing importance accorded to patients and their role as valuable sources of clinical knowledge

Mending Bodies, Saving Souls, A History of Hospitals, 1999

Based on original clinical notes from the distinguished French physician René T. Laennec (1781-18... more Based on original clinical notes from the distinguished French physician René T. Laennec (1781-1826), then a resident physician at the Necker Hospital during the 1810s in Post-revolutionary Paris, this chapter follows the institutional experiences of a retired soldier afflicted with pulmonary tuberculosis. The story allows for both an in-depth look at hospital life in a charitable parish establishment while also enabling a comprehensive overview concerning the evolution of contemporary French medicine. Further context is provided, including the institutional transitions from the Ancient Régime and the new approaches to medical research and teaching that shaped the foundations of modern Western medicine.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter tells the story of four women living in Rome who contracted bubonic plague during an... more This chapter tells the story of four women living in Rome who contracted bubonic plague during an epidemic afflicting the city in 1656. The account first traces the movement of the disease throughout Europe since the Black Death as well as its transmission via trade to the Roman slums of Trastevere. Responding to the challenge, a papal Health Congregation adopted stringent and traditional methods of containment, including inspections and quarantines. Moreover, the authorities established pest houses or lazarettos to house people suspected of suffering from plague. A historical review of public health measures follows, especially providing details about pest houses, their location, functions, staffing, and caregivers. A final section describes the development of a lazaretto on Tiber Island, destination for the featured plague patients from Trastevere. Their institutional journey is reconstructed on the basis of contemporary accounts, including nursing and medical routines.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

Devoted to hospitals as tools for segregation and confinement, this chapter features the story of... more Devoted to hospitals as tools for segregation and confinement, this chapter features the story of Grette S. Thielen, a married parishioner from the town of Diedenhofen in the Lorraine. Suspected by neighbors of suffering from leprosy, the woman was sent in June 1492 for diagnostic inspections, including an official probe in Cologne by a special medical panel. The narrative explains the proceedings within the context of contemporary views of this disfiguring ailment and the stigma attached to it. Medical confirmation forced the unfortunate Grette to be ritually separated from the community and probably conveyed to a prominent Lower Rhine leper house at Melaten, near Cologne. Subsequent sections explain the evolution of such institutions in medieval Europe with a focus on institutional life and rituals.

The Oxford Encyclopedia of the Modern World, 2008

From their very inception, hospitals were envisioned as religious spaces, shelters, hospices and ... more From their very inception, hospitals were envisioned as religious spaces, shelters, hospices and places of confinement. Since early Christian theology readily accepted the role of medicine in charitable works, these institutions also focused on the cure of ailments under the supervision of consulting physicians and surgeons. Boundaries between the various functions remained fluid until early modern times. This overview highlights developments since 1800.

Mending Bodies, Saving Souls: A History of Hospitals, Mar 1999

This chapter is devoted to the study of famous late nineteenth-century hospitals, highlighting th... more This chapter is devoted to the study of famous late nineteenth-century hospitals, highlighting the limitations of medical science. Showcased is the Eppendorf General Hospital in Hamburg during the 1892 outbreak of cholera in that port city. Considered a model for the world, the recently completed pavilion-style complex had a capacity of nearly 1,300 beds distributed over 200 wards. When cholera struck in the late summer and the number of sufferers soared, this municipal institution became a prominent recipient of cases urgently in need of isolation and treatment. Based on medical records, institutional sources, and journalistic accounts, the story is told in detail by following a typical patient, Erika W., an adult woman collapsing in a squalid tenement neighborhood of the city and taken to the institution. Under threat of cholera outbreaks in the 1880s, a section discusses the planning and construction of the Eppendorf General. A sketch of contemporary bacteriological views concerning cholera’s etiological agent follows, based on research pioneered by the prominent medical scientist Robert Koch. While the Eppendorf lacked academic affiliations, its leaders attempted to stress the importance of clinical research, but physicians and nurses remained in short supply during the emergency. A conclusion discusses the hospital’s mediocre performance at the dawn of the bacteriological age, ambushed by a fast killing contagion, organizational snags, staff deficiencies, and inadequate medical treatments.

Mending Bodies, Saving Souls,: A History of Hospitals, 1999

This chapter offers a unique snapshot of Baltimore’s Johns Hopkins Hospital, based on the experie... more This chapter offers a unique snapshot of Baltimore’s Johns Hopkins Hospital, based on the experiences of a young mans suffering from typhoid fever and admitted to the institution in 1891. Much has been written about this establishment, its railroad tycoon founder and the expertise of medical officer John S. Billings hired to supervise the project. A section summarizes the planning and building of the pavilion-style hospital. Organized as a care and teaching facility, it finally opened in 1889, after more than a decade of construction. Another segment deals with the medical and nursing staffs, led by the famous clinician William Osler and nursing superintendent Isabel A. Hampton, their backgrounds and philosophies of patient care. Against this institutional background, the essay focuses in considerable detail on life in the hospital and the contemporary challenges of managing typhoid fever. Following the patient’s demise, an epilogue comments on the Oslerian concept of the hospital as clinical laboratory and the partnership of science and religion in an era of therapeutic skepticism.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter features the personal stories of three California women who were admitted in Septemb... more This chapter features the personal stories of three California women who were admitted in September 1984 to the Kidney Transplantation Unit at the University of California, San Francisco. Based on detailed interviews with patients, caregivers, and administrators, a vivid and candid picture of their experiences before, during, and after surgery emerges. The topic was selected as one of the most salient examples of the evolution of modern hospitals into science-based showcases. After discussing the development of this surgical procedure and contemporary ethical issues surrounding organ donation, the narrative sketches the transformation of American university hospitals into academic centers since 1900, and their progressive role in biomedical research and provision of tertiary medical care. Another section illuminates the transition of UCSF from its modest proprietary beginnings to becoming one of the leading medical research and education institutions in California. Also briefly sketched is the university’s role in the modern era of kidney transplantation that included some of the pioneers in the field. In fact, by 1978, the UCSF Transplantation Service celebrated its first 1000 successful grafting operations, subsequently becoming a world-class program attracting patients from around the globe. Housed at the Moffitt Hospital, the unit partnered with other medical specialties—notably nephrology—and special nursing services. A final section explains subsequent developments and dilemmas surrounding America’s transplantation surgery in an era of fragmentation and high costs in our health care system.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter recounts the experiences of Margaret Mathewson, a young woman from the Shetland Isla... more This chapter recounts the experiences of Margaret Mathewson, a young woman from the Shetland Islands who sought admission for an infected shoulder at the Royal Infirmary of Edinburgh in 1899. The story is based on the patient’ own written account of her eight-month hospital experience, including a surgical procedure performed by Joseph Lister, one of Britain’s most celebrated surgeons who pioneered antiseptic methods. To contextualize Mathewson’s unique narrative, the essay portrays the dangers of “hospitalism”--lack of institutional hygiene—revisiting its dangers and lethal effects for patients during surgery and postoperative recovery. After recounting the evolution of surgery in Victorian Scotland, another section summarizes the vital importance of the “new” nursing led by Florence Nightingale’s reforms and their successful introduction in Edinburgh. The role of Lister, who operated on Mathewson employing his antiseptic system of surgery, follows. The surgeon’s relationship with his Infirmary patients provides a unique window into late nineteenth century hospital life and patient/physician relationship. In the final analysis, Lister’s surgical “revolution” did not derive from on a single innovation, the use of carbolic acid. It was accomplished by a convergence of factors, including better anesthesia, institutional hygiene and modern nursing.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter depicts the “discovery” of ether anesthesia at the Massachusetts General Hospital wi... more This chapter depicts the “discovery” of ether anesthesia at the Massachusetts General Hospital within the context of Boston medicine, surgery and dentistry, discussing the local struggles for professional and cultural identity within an environment of sectarianism and professional secrecy. For this purpose, the narrative uses the story of Alice Mohan who actually became the first patient submitting to full ether inhalation for the amputation of her right leg. Mohan’s successful major surgery, performed on November 7, 1846, followed a prior, famous but brief attempt to remove Gilbert Abbott’s congenital neck tumor that forever put Boston and America on the list of pioneering surgical achievements. More than Abbott’s case, Mohan’s long pre-operative hospitalization and botched treatments provide a rare view into the state of contemporary medical therapeutics and the evolution of the Massachusetts General Hospital.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter recounts the story of Warren, a young gay man living in the Castro neighborhood of S... more This chapter recounts the story of Warren, a young gay man living in the Castro neighborhood of San Francisco during the early 1980s. Writer, performer and artist, Warren’s health deteriorated and by December 1983 he was diagnosed with AIDS, then admitted to San Francisco General Hospital’s new 5B ward. Based on interviews with friends and caregivers, the narrative follows Warren’s downhill course in the context of the hospital’s history, evolution of the AIDS concept, and its implications for medical science and public health. Readers will also find background information about the planning of the “AIDS Ward” within the emergent gay pride movement and development of a new ethos concerning the rights and responsibilities of stigmatized patients suffering from the new disease. A section devoted to life in Ward 5 B also exposes novel views regarding death and dying. A postscript examines possible “lessons” from Warren’s experiences with attention to the so-called “San Francisco Model” of AIDS care and the exposure of critical fault lines in the contemporary American health care system.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter narrates the creation of civil and military shelters for the care of soldiers and sl... more This chapter narrates the creation of civil and military shelters for the care of soldiers and slaves in Imperial Rome through the lens of Claudius Terentianus, an enlisted marine from Emperor Trajan’s Alexandrian fleet. In the summer of 115 AD the sailor fell ill on board of his ship while in port and he described his troubles with the help of a scribe in a series of communications to his father. The letters offer a window into the historical circumstances that led to the creation of these institutions, explaining their mission, architectural features and organization, as well as caregiving staff and treatments. Together with the Greek Asclepieion, the Roman valetudinarium represents an early example of the confluence between the sacred and secular.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter reconstructs the story of a suffering Aelius Aristides, a famous and wealthy orator ... more This chapter reconstructs the story of a suffering Aelius Aristides, a famous and wealthy orator from Mysia in Asia Minor who in the year 145 AD sought advice from Asclepius, the former hero and divine healer at his temple in Pergamon. Aristides “Sacred Tales” of the encounter with the god not only shed light on the management of life problems during the Roman Empire, but they also illuminate in detail the ideology and staging of ancient healing rites, especially the employment of dreams and their interpretation for achieving cures.

The Cambridge World History of Human Disease, 1993

Companion Encyclopedia of the History of Medicine, 1993

Medical care is a complex transaction involving a variety of individuals placed in distinctive an... more Medical care is a complex transaction involving a variety of individuals placed in distinctive and interconnected sick and caring roles. This synthesis describes the historical development of a variety of healing networks, beginning with shamanistic practices in pre-literary societies, followed by the emergence of a secular healing craft in ancient Greece and Rome. The advent of Christianity dramatically altered previous patterns since physical welfare became subservient to spiritual salvation. By the Renaissance, urban European states sponsored and organized and credentialed medical and surgical groups providing assistance. In subsequent centuries, these professionals developed new approaches to care based on a growing body of human anatomical and physiological knowledge. Today, a transcultural, scientifically based biomedicine predominates around the globe, part of a pluralistic system of care that also offers self-help, domestic folk and ethnic-grounded assistance, as well as alternative or complementary schemes.

To illustrate the significant institutional transformations experienced by health care's top inst... more To illustrate the significant institutional transformations experienced by health care's top institution, twelve historical case studies are presented. Such framing allows authors to present contingent and richly documented accounts in a chronologically arranged manner stretching from medieval times to the present. A new and important subject, hospital life, features a detailed analysis of the social, economic, and cultural circumstances responsible for the changes. The new collection contains additional essays delivered during a previous conference, also sponsored by the International Network for the History of Hospitals (INHH) established in 1995.

Isis, 1990

Book review of two prominent books dealing with the impact of 19th-century Western medicine as a... more Book review of two prominent books dealing with the impact of 19th-century Western medicine as an agent of colonization.

Diagnosis has moved to the center of modern medical practice. The thesis of this work is that a ... more Diagnosis has moved to the center of modern medical practice. The thesis of this work is that a critical shift in medical theory and practice occurred in Germany around 1800.

In this new edition, the author, an Egyptian physician, places more emphasis on medical specializ... more In this new edition, the author, an Egyptian physician, places more emphasis on medical specialization in Ancient Egypt. This book valuable information for the general reader.

JAMA: The Journal of the American Medical Association, 1997

ABSTRACT Medical history has shifted focus from the accomplishments of great doctors and nurses t... more ABSTRACT Medical history has shifted focus from the accomplishments of great doctors and nurses to a closer examination of the cultural context in which all health-related activities necessarily take place.The view "from below" prominently involves patients and their families as well as less formal healing networks populated by individuals often branded as opportunistic quacks or magicians.This form of cultural history is difficult to research and write. It requires extensive archival research and an open mind, ready to jettison some of the most cherished preconceptions held by contemporary practitioners of the craft. Lindemann's study centers on the north German duchy of Braunschweig-Wolfenbuttel during the 18th century, but her conclusions address broader issues in European and medical history. Her multiple sources are mostly individual narratives of illness and healing, collected for bureaucratic reasons from parish records, case histories, and investigations of quacks. In a reflection of corporate mentality derived from the

Endeavour, 1993

Page 1. CHARLES E. ROSENBERG EXPLAINING EPIDEMICSf and Other Studies in the History of Medicine -... more Page 1. CHARLES E. ROSENBERG EXPLAINING EPIDEMICSf and Other Studies in the History of Medicine - v Page 2. Page 3. Explaining epidemics and other studies in the history of medicine This book brings together for the ...

Perspectives in Biology and Medicine, Jan 2002

In this condensed analysis of American health policy during the past half century, Eli Ginzberg, ... more In this condensed analysis of American health policy during the past half century, Eli Ginzberg, a noted health economist at Columbia University, focuses on developments since the end of World War II, paying particular attention to the fate of prominent academic health centers.

JAMA: The Journal of the American Medical Association, 1974

... Galenism; rise and decline of a medical philosophy. Post a Comment. CONTRIBUTORS: Author: Tem... more ... Galenism; rise and decline of a medical philosophy. Post a Comment. CONTRIBUTORS: Author: Temkin, Owsei (b. 1902, d. ----. ... PAGES (INTRO/BODY): xxii, 240 p. SUBJECT(S): Medicine;Philosophy, Medical; Philosophy; History; Galen. DISCIPLINE: No discipline assigned. ...

The American Historical Review, 1992

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The American Historical Review, 1989

The American Historical Review, 1988

William Hunter ANDTHE EIGHTEENTH~CENTURY MEDICAL WORLD Edited by WF Bynum and Roy Porter ... Will... more William Hunter ANDTHE EIGHTEENTH~CENTURY MEDICAL WORLD Edited by WF Bynum and Roy Porter ... William Hunter and the eighteenth-century medical world ... William Hunter and the eighteenth-century medical world EDITED BY WF BYNUM ...

The American Historical Review, 1988

The Johns Hopkins School of Hygiene and Public Health is one of the finest schools of its kind in... more The Johns Hopkins School of Hygiene and Public Health is one of the finest schools of its kind in the world. Its historical importance stems nut only from the quality of its faculty and graduates and their impact on public health, but also from the fact that the school played a crucial ...

The American Historical Review, 1996

Bulletin of the History of Medicine, 2006

ABSTRACT Bulletin of the History of Medicine 80.2 (2006) 369-371 Writing one's day-to-day... more ABSTRACT Bulletin of the History of Medicine 80.2 (2006) 369-371 Writing one's day-to-day experiences has become a popular literary genre, displaying the variety and richness of human life. Sharing information today through blogs or online diaries contributes to our understanding of events and personalities. This anonymous journal, written by a British medical student, highlights his impressions about the academic year before graduation that he spent in Paris between 1 November 1834 and 30 June 1835. The author, enrolled at the University of Edinburgh, was among many foreigners eager to supplement their studies in what was then unquestionably the mecca of Western medicine. The text offers a valuable window into the workings of the renowned Paris Medical School. The unfiltered daily entries reveal a highly motivated and curious medical student determined to make the most of his limited sojourn in the City of Lights. Frugal, searching for cheap lodgings and meals, eschewing a busy social life, he comes across as an extremely focused individual busily shuttling between teaching hospitals from early morning to evening—including Sundays—to witness clinical rounds, surgical procedures, and autopsies. Interspersed between his hastily written observations are brief expressions of ambiguity about French culture and religion. As time wore on, the student's mood grew hostile; he seemed to perceive that every Frenchman took delight in taking advantage of "raw" Englishmen. "This beastly Paris," he commented on Christmas 1834, "I detest it more and more everyday of my life" (p. 91). What is missing from the diary, however, are thoughtful reflections about his experiences. Time, of course, was of the essence, "interesting" patients the goal. The diary is full of passing comments about seeing "capital cases," "absolutely nothing of any consequence," "can't say I much benefited." The Parisian hospitals and clinics were, of course, veritable museums of pathology, with human specimens drawn from the poorer sectors of a metropolis suffering from numerous "fevers," prominently including tuberculosis, typhoid fever, and syphilis. There are also glimpses of practical skills that this British student definitely wanted to learn. In addition to "walking" the wards, he enrolled in special evening sessions conducted by midwives on the use of the vaginal speculum and forceps, and a private course on diagnosis through the use of the stethoscope and percussion hammer. The downside of a medical education in Paris can be inferred from vivid comments about the large number of students crowding the hospital wards, lecture rooms, and autopsy tables. Rounds by medical luminaries, who were in charge of many patients, could be very speedy and perfunctory, with magisterial comments muffled by the distance from the selected inmate and drowned out by the usual hustle and bustle prevailing in the ample wards. Lecture rooms to witness surgery or case presentations filled up quickly, with eager students even seeking seats during prior, less popular lectures in order to prevent having to hover outside the doorways. Moreover, the diarist was uncomfortable with the dehumanizing approach to French patients, specifically commenting on famous surgeons—cruel "slashers"—who were more interested in developing their techniques than concerned with the welfare of their charges. However, the diary remains silent about the two major criticisms made by other foreign visitors. The first is the almost total passivity of a Parisian education except for the house staff, the appointed "élèves internes": foreign students observed too much but personally did very little. The sensory overload with "capital" cases was often ephemeral and unstructured, and proved dehumanizing. Finally, while a year spent in Paris could have definitely enhanced professional prestige, how much did it actually matter for subsequent private practice in an English town? The observed clinical spectrum assembled in Parisian hospitals reflected the risks and ecology of disease typical of a great European metropolis. It is doubtful whether the British diarist—tentatively identified as James Surrage of Clifton—would have encountered and managed many of these ailments and...

Journal of Social History, 1999

Journal of Social History, 1991

Perspectives in Biology and Medicine, 2002

ABSTRACT In lieu of an abstract, here is a brief excerpt of the content: Perspectives in Biology ... more ABSTRACT In lieu of an abstract, here is a brief excerpt of the content: Perspectives in Biology and Medicine 45.3 (2002) 470-472 Book Review Pharmacopoeias and Related Literature in Britain and America, 1618-1847 Pharmacopoeias and Related Literature in Britain and America, 1618-1847. By David L. Cowen. Brookfield, VT: Ashgate, 2001. Pp. viii + 296, $105.95. Thirteen articles, written by David Cowen between 1951 and 1987 and originally published separately in a number of journals, appear together for the first time. Several of them are entirely bibliographic, meant to document the existence of publications on the subject. Cowen, a historian of pharmacy, decided to reprint them because—in his opinion—historians have paid too little attention to therapeutics and treatments with drugs, a central concern of practicing physicians through the ages. Indeed, the historiography on this subject has taken diverse paths of inquiry that must be combined before fruitful insights can be gained. Physicians and pharmacists look narrowly at old remedies, trying to find out what actually worked from a pharmacological point of view. They are usually quite disappointed about what they find and thus become quite dismissive of historical medicine as placebo. Historians of science check the impact of the scientific revolution and the advent of modern chemistry on medicine and pharmacy, often with meager results. Finally, social historians examine the implications of drug prescribing for both patients and physicians, and the role it played in the construction of their relationship but often fail to recognize the symbolic meanings of such interactions. Cowen's papers range widely in size and subject, from Enlightenment Edinburgh medicine to Pennsylvania Dutch folklore healing, Colonial veterinary tracts to the New York Hospital drug reference book. Nevertheless, the collection retains a certain thematic unity: the need to compile, classify, and explain the action of substances believed to possess a favorable medicinal action. Today, the term pharmacopoeia is given to a number of publications, including the official and complete drug listings of the U.S. Pharmacopoeia (1997) and more abridged, "lab-coat pocket" works listing selected preparations and their optimal dosage. There are also works separating prescription from over-the-counter preparations, generic and brand-name drugs, and even formularies that list the powers of medicinal plants and their potential poisonous side effects. Beginning in the late 17th century, however, the vast number of animal, plant, and mineral materials believed to contain healing qualities was collected and arranged, then published, resulting in erudite Latin editions prepared under the sponsorship of elite medical organizations located in some of the most important cities of Europe. Several of Cowen's articles draw attention to the Royal College of Physicians of Edinburgh, which sponsored its first official pharmacopoeia in 1683. He insightfully explains that such a task was conceived as a weapon in the contemporary professional struggles between physicians, apothecaries, and surgeons. By virtue of their charter and statute, elite medical corporations wished to assert their traditional control over apothecaries as they began to separate from their fellow surgeons. At the same time, such colleges were determined to set boundaries in the medical marketplace between the therapeutic armamentarium of educated physicians and the large groups of unorthodox healers with their own claims for cures. In sanctioning a list of preparations, the Royal College of Physicians of Edinburgh placed its own stamp of approval on items that lent legitimacy to the practicing medical man. This is revealed in the rhetoric employed during the creation of such pharmacopoeias, where complaints about the older remedies were expressed in code words such as "superstition," when referring to persisting folk remedies, "credulity," when referring to the power of authority, and "established custom," when referring to tradition. Cowen then walks the reader through successive editions of this work, with their gradual elimination of numerous compounds touted as "rational cleansing"—although many of the exclusions were simply the result of empirical clinical experiences that revealed the compounds' inefficacy. For its part, chemical nomenclature invaded the classifications. By the early 19th century, the range of what was considered materia medica had dwindled considerably, in part through the elimination of household remedies considered superfluous in a professional compendium. In time, the Edinburgh Pharmacopoeia, with its abridgments and dispensatories, became one of the most influential works about the nature...

unpublished, 1992

Medical theory and practice play important roles and are closely linked to professional struggles... more Medical theory and practice play important roles and are closely linked to professional struggles concerned with physicians’ identity, status, and income. This essay reviews developments in Central Europe between 1780 and the early 1800s, focusing on efforts to overturn the prevailing and often confusing mechanical and chemical notions of bodily function established during the Enlightenment. Except for a few larger urban centers, Germany remained a medley of some 360 sovereign principalities, bishoprics, and free cities flanked by Prussia and Austria. The region still adhered to the traditional division of physicians, surgeons, and folk healers, a situation that perpetuated lower standards of education and practice, insufficient clinical training and lack of hospital facilities. The paper discusses the search for a new and coherent theoretical system and the adoption of ideas presented in a controversial book, Elementa Medicinae (1780), written by Scotland’s rather infamous physician, John Brown (1735-1788). “Brownianism” or better known on the Continent by its Latinized version “Brunonianism” became the subject of extensive debates involving rulers, philosophers, poets, and academic physicians.

Brownianism also popularly known as “Brunonianism” was a medical doctrine and clinical practice e... more Brownianism also popularly known as “Brunonianism” was a medical doctrine and clinical practice elaborated towards the end of the eighteenth century in Scotland by the physician John Brown (1735-1788), a former student at Edinburgh University. Since his theory and treatments generated lively and acrimonious debates among contemporary physicians in Europe and America, this essay reexamines the fate of Brown’s system within contrasting philosophical, social, and professional contexts in Scotland and Germany.

The Enlightenment promoted efforts to recognize current medical knowledge on the basis of fundame... more The Enlightenment promoted efforts to recognize current medical knowledge on the basis of fundamental laws governing the phenomena of human health and disease. This overview features a portrait of one of the most recognized 18 th century individuals, the Scottish physician William Cullen, who sought to create a novel medical system based on new scientific data pertaining to the nervous system. Together with biographical details, Cullen's efforts are placed in context with his roles as an academic, practitioner, hygienist, hospitalist, and educator.

The essay, therefore, attempts to gather and analyze information bearing on medicine in the early... more The essay, therefore, attempts to gather and analyze information bearing on medicine in the early years of the Republic insofar as it was perceived as a distinctive national, “American” character. Within that context, I attempted to distinguish three aspects: the New World’s ecological framework shaping health and disease, the post-revolutionary theory and practice of medicine, and finally an assessment of medical progress achieved during the first generation of truly free Americans

Our health-conscious culture remains obsessed with the threats posed by a number of traditional a... more Our health-conscious culture remains obsessed with the threats posed by a number of traditional and newly emerging diseases. Malaria, AIDS, cancer, SARS, Ebola fever, and avian influenza continue to be portrayed as global menaces. Bioterrorism employing agents responsible for anthrax, smallpox, and plague also looms darkly. The recent mood is almost apocalyptic. Scientists, from historical ecologists to evolutionary molecular biologists, together with experts in social bioarcheology and paleopathology, are all actively studying the complex web of relationships between nature, human culture, and disease. Their recent discoveries are providing new and often revolutionary insights into present and past health events. Should historians become aware and take advantage of this growing body of knowledge for their future questions, interpretations, and reconstructions? In spite of such highly specialized research as well as constant updates and revisions employing an array of ever-more sophisticated technologies, are there possibilities of collaboration? Based on four distinct case studies ranging from the Neolithic era to the 20 th century, this essay proposes a new bio-cultural history of health, disease, and medicine combining the latest scientific findings with insights derived from social, political, economic and cultural theories and relationships. While difficult to achieve, this synthesis promises to offer a far more nuanced picture and understanding of human life and health, as well as explain both the biological and political roots of disease at the global level.

Autobiographical account and historiographical analysis from the author of Mending Bodies, Saving... more Autobiographical account and historiographical analysis from the author of Mending Bodies, Saving Souls: A History of Hospitals, (Oxford Univ. Press, 1999) about his motives and efforts to plan and write this book with special emphasis on patient-centered narratives.

Based on personal experiences of its founder, Samuel Hahnemann, homeopathy began as a medicinal r... more Based on personal experiences of its founder, Samuel Hahnemann, homeopathy began as a medicinal reform movement in the eighteenth century. Frequently featured as an alternative to regular, often labeled " heroic " medicine, this medical system spread from Europe to America and even Asia, particularly India during a period of significant therapeutic skepticism and even nihilism. This essay revisits the genesis of homeopathy's most fundamental principle, similia similibus curantur, (likes are cured by likes) within its unique historical circumstances.

The theory and practice of homeopathy are inextricably linked to the personality and life experie... more The theory and practice of homeopathy are inextricably linked to the personality and life experiences of its founder, the German physician Samuel Hahnemann (1755-1843). The essay sketches this novel approach to medicine stressing its roots in the European Enlightenment as well as exploring a constellation of factors responsible for its subsequent therapeutic successes and professional respectability.

This essay examines the famous 1900 outbreak of bubonic plague in San Francisco's Chinatown based... more This essay examines the famous 1900 outbreak of bubonic plague in San Francisco's Chinatown based on perceptions and beliefs of contemporaries confronted with a similar recent event in Honolulu, Hawaii. In that city, a controlled fire ordered by public health officials to cleanse the Chinese quarter of contagion accidentally destroyed it, forcing its entire population to abandon their homes. However, in San Francisco, similar sanitary measures were successfully blocked with the help of federal judges by a better organized and defiant Chinese community. San Franciscans viewed the Honolulu plague episode as a direct antecedent to events in their port city also actively involved in the burgeoning Trans-Pacific trade, and its perceived "lessons" significantly influenced the responses. The city also had a district with substandard housing crowded exclusively with Asians. Unlike Honolulu, however, Chinatown was tightly squeezed into 15 blocks of real estate with an overwhelmingly Chinese population of about 14,000 males. Very few were allowed to live elsewhere. To reproduce the spatial intimacy prevalent in their original villages, the new arrivals since the Gold Rush had altered the city's gridiron by creating a number of makeshift pedestrian alleys between regular city blocks. As the population grew and density increased, faulty privy vaults and drains sprouted everywhere and a system of basements and tunnels was created linking major buildings. Food markets, restaurants and butcher shops with their live chicken and other animals contributed to the filth, garbage, and inevitably rats.

Defined by the medical laboratory in 1900, the arrival of bubonic plague in San Francisco precipi... more Defined by the medical laboratory in 1900, the arrival of bubonic plague in San Francisco precipitated a lengthy contest between California bacteriologists, clinicians, politicians, merchants, journalists, and elected officials. With profound implications for political dominance and commercial success, the reputation of medical science in the identification of infectious diseases and accordingly the execution of public health measures were at stake.

Policies designed to improve the public's health in the face of epidemics are quite old. Often in... more Policies designed to improve the public's health in the face of epidemics are quite old. Often intrusive as well as stigmatizing, they were based on contemporary cultural assumptions and scientific knowledge about the nature of health and disease. To fully understand their meaning and implementation, we must therefore historicize individual epidemic episodes and explore them in their full context and complexity. The 1900 outbreak of bubonic plague in San Francisco's Chinatown provides such a window by exposing the struggle between its inhabitants and the local, state and federal government authorities in an atmosphere of blatant racism, civil rights, and the new Pasteurian science.

Much has been written about San Francisco’s Chinatown. Ever since its inception following the Cal... more Much has been written about San Francisco’s Chinatown. Ever since its inception following the California Gold Rush of 1849, this part of the city came to be portrayed as a dangerous “plague spot,” a breeding place of filth, bad smells, and disease. The perceived sanitary deficiencies, blamed on the entire Chinese population, played a key role in characterizing the district as a threat to the rest of San Francisco and beyond. For more than half a century, medical representations, heavily tinged with racism and exoticism, were amplified and diffused by a sensational print media and found widespread acceptance among contemporaries. In fact, the sanitary argument came to underpin other political, social, and cultural considerations portraying the Chinese collective in California. Why and how did this happen? What was the basis for such assumptions? This case study revisits the tainted image of Chinatown by framing it within a broader reality. The analysis aims to demonstrate the need for a more complex framework, closely linking geographical, ecological, biological, and cultural perspectives for revising and amplifying our historical understanding.

Epidemics present a unique blend of contemporary ecological factors within highly specific cultur... more Epidemics present a unique blend of contemporary ecological factors within highly specific cultural, political, and economic circumstances. Nevertheless, in light of the current response to the AIDS/HIV epidemic, this analysis offers a comparative historical example of mass disease--the plague epidemic that afflicted Rome in 1656—to examine traditional public health policies. The outbreak in Rome is placed within the context of 17th century Baroque culture, urbanization, Papal politics, wars, and trading patterns. Applying methods of quarantine and isolation developed during the Black Death, public health officials during the papacy of Alexander VII engaged in a series of aggressive and costly measures. They included closing the city gates, restricting the movement of residents, and segregating large sectors of the population. Moreover, police initiated extensive house searches and closures as well as destructive cleansing campaigns, leading to stigmatization, evasion, and resistance. The heavy-handed approach included the public execution of individuals violating curfew rules demonstrating that implementation of such measures can have unwanted consequences.

This lecture, originally a draft for a chapter in Mending Bodies, Saving Souls: A History of Hosp... more This lecture, originally a draft for a chapter in Mending Bodies, Saving Souls: A History of Hospitals (1999), describes the creation of a new specialized hospital in Europe, especially South Germany, devoted to the treatment of venereal syphilis, a recent and presumed import from the New World. Sponsored by municipal authorities and private interests, these “pox houses” emerged in major urban centers. The narrative focuses on the city of Augsburg at the end of the 15th century, featuring the Holzhaus (wood house), an institution promoted by the Fuggers, a prominent mercantile family involved in trade with the newly discovered American continent. An exploration of its mission, patronage, and physical plant sets the stage for a more detailed view of staff and patients. Finally, a personal memoir serves as an introduction to the complex and aggressive therapeutic approaches employed in the management of syphilis cases, notably the use of guaiacum wood powder as substitute for toxic quantities of mercury.

This brief essay serves as an introduction to a international conference on the current status of... more This brief essay serves as an introduction to a international conference on the current status of physician assisted dying prompted by US Supreme Court hearings on this topic and growing medical acceptance of such practices here and abroad. This conference is devoted to an examination of physician-assisted dying in history. We have purposely avoided the term euthanasia-eu good, thanatos death-coined by Francis

Culled from William Osler’s notebooks, this case of pulmonary tuberculosis admitted to the recent... more Culled from William Osler’s notebooks, this case of pulmonary tuberculosis admitted to the recently completed Johns Hopkins Hospital in Baltimore reflects the state of medical management just prior the much-heralded advent of Robert Koch’s tuberculin.

Delivered in Greece during a tour sponsored by the University of California, this unpublished lec... more Delivered in Greece during a tour sponsored by the University of California, this unpublished lecture supplements an earlier talk about the construction of Christian philanthropy and care of the sick. Under the patronage of local bishops, this address describes the creation of institutions that provided hospitality, shelter and even medical assistance in the Byzantine Empire.

This unpublished lecture, delivered in Greece during a tour sponsored by the University of Califo... more This unpublished lecture, delivered in Greece during a tour sponsored by the University of California in May 2008 attempts to sketch the institutionalization of Christian philanthropy and its obligation to care for the sick.

Question & Answer session Discussion of the new book

Like most scholars, historians dealing with the medical past periodically explore and comment on ... more Like most scholars, historians dealing with the medical past periodically explore and comment on the shifting contours of their distinctive field of studies. 1 While favoring particular theoretical approaches, historiographical reviews also aim at uncovering neglected areas of research and identify new communities of scholarship. 2 Predictably, such explorations are based on individual academic credentials and pedagogical exposures. With the help of specific examples and abundant references, the objective of this essay was to collect and update previous schemes, stressing the fact that the field is currently witnessing a dramatic expansion of subjects, approaches, practitioners, and audiences. From a narrow pursuit of professional roots, a multidisciplinary history of medicine now includes among its subjects the shifting ecology of human health and disease, cultural factors of illness causation and prevention, as well as economic burdens of poverty and pharmacological intervention. 3

Unpublished lecture delivered by the 18th-century Scottish physician William Cullen. The fragment... more Unpublished lecture delivered by the 18th-century Scottish physician William Cullen. The fragment was obtained from the Cullen papers, Ms. Collection, University of Glasgow.

The History of John Brown's Medical System in Germany During the Years 1790-1806, 1971