Locating Medical History: The Stories and Their Meanings

1 Medical Histories

C H A P T E R O N E Medical Histories Frank Huisman and John Harley Warner Historians of medicine tend to be very ready to assert that the past gives important perspective on the present—that understanding the experience and management of illness in the past can aid patients, clinicians, policy makers, public health officials, ethicists, and voting citizens as they make difficult choices. Some historians are explicit about their conviction that tracing how earlier societies responded to epidemics, for example, or how they drew distinctions between the normal and the pathological, can help guide individuals, professions, and states today toward more effective and more just interpretations and interventions. Others write histories of medicine convinced that displaying a rich professional heritage offers intellectual satisfaction and reassurance to clinicians as they face daunting workaday demands. Still others see history as a vehicle for helping medical students make sense of the professional culture they are entering and realize their own agency as the pressures of socialization take their toll. Even medical historians openly wary about drawing lessons from the past are often quick to recognize the potential of historical perspective to aid a woman confronting childbirth, an adolescent coming to terms with her or his own body, or all of us in comprehending the ways in which culture shapes our sense of self in sickness and in health. 2 Locating Medical History It is therefore surprising that a community so intent on calling attention to the salience of the past for the present has generally been roundly dismissive of the past of its own craft. During the last several decades, ‘‘traditional’’ medical history has been most frequently brought forward as a simplistic straw figure, cited only that it may be trounced. Authors who are decreasingly likely to have read work from the field’s early years often assail that work in order to enhance the importance and novelty of their own contributions. Such historiographic posturing is a built-in rhetorical strategy in virtually all fields of history. Nevertheless, it remains ironic that, as historians of medicine, most of us reflect so little on the past of our own enterprise as we shape and reshape our historical practice. Our aim in this volume is neither to defend nor to rehabilitate earlier approaches to medical history. However, we do want to challenge the now commonplace depiction of ‘‘traditional’’ medical history. In the new social history of medicine that took shape in the 1970s, the deployment of a flat caricature of older work helped to define the new program and to clarify a sense of mission for historians trying to consolidate their separate identity. Indeed, that movement gained in momentum partly by contrast with what it was not—the established, establishment medical history written exclusively by physicians for other physicians , consecrated to heroic celebration of great doctors and their achievements, Whiggish and triumphalist, unapologetically internalistic and naively positivist. By the early 1980s, this image of traditional history degenerated from an inspiring rallying call for historiographic revolution to an assumed but unexamined misrepresentation of the past. During the 1980s and 1990s, invoking this stereotype had too often become a de facto substitute for fresh theoretical engagement and analysis. In book introductions , journal articles, and grant applications, parading an older medical history only to denounce it provided a readily available and intellectually undemanding way of asserting the importance of one’s own work. This is one of the reasons why much work that is ‘‘intellectually flatfooted and theoretically unre- flective’’ (as Roger Cooter puts it in chapter 14 of this volume) has managed to pass muster. Perhaps one of the best things we could do for our field is to make it disreputable to trot out ‘‘traditional’’ medical history as a simplistic foil, a maneuver that too long, too often has passed for theoretical and historiographic novelty. More than this, invidious depictions of the past are often covert dismissals of other genres of medical history in the present, and precisely because these dismissals tend to be covert rather than open, they bypass any occasion for critical dialog. Dismissing approaches other than our own spares us the labor of spelling out our historiographic aims and allegiances while foreclosing opportunities for Medical Histories 3 the kinds of debate that can keep a field vital. As individual writers we can perhaps dispense with such self-reflection and get on with our...