Key Lecture Summaries Flashcards
Pyramid model
Physician
Surgeon
Apothecaries
Irregular practitioners
People at the top fewer and more powerful than those below - distinction between learned and practical knowledge; a hierarchy build on book learning
Physicians
- Regulated by the colleges
- Trained in universities
- Located in urban centres
- Based on guild model
- Worked to regulate # of physicians practicing
- Had jurisdiction over everyone else practising medicine generally
- Dispensed advice
Surgeon
- Trained by apprenticeship
- often literate
- Techniques learnt on the job rather than through study
Agency in the medical counter
Use of the word patient suggests an isolated passive subject
Social networks
Ill persons as part of a network, with agency- suffers, not patients
Passive subject of illness, not the medical practitioner
More explicit range of medical practitioner =
more explicit agency of the patient
Objectives of patient centred hsitory
- Recover the dynamics of healing
- Get an accurate representation of suffering/patient perspective/history of the body
Gendered Bodies
Natural body a construction
Women’s bodies different from men’s bodies as they followed a rhythm of periodic bleeding/birthing which made them fundamentally different to men
Fluid Bodies
Humoral body about flow, not balance- getting things out the system, not maintaining it
History of emotions is underpinned by
hydraulic model [Rosenwein]
Death rate in the black death
1/3-1/5 European population died
Historiography of the plague
pre 1970s: horror of disease and powerlessness of people
post 1980s: chart responses - prayer, avoidance, individual and civic response.
Weisser
Disease not discrete entities, but as continually shifting clusters of symptoms
Galen:
imbalanced state of the body prevents it from functioning.
Early modern economy
Capacious meaning: defined as the management or organisation of a system, be that commercial, domestic or spiritual- a way of organising behaviour.
Long 18th century as seeing a rise of
mdicl commodities and monetarisation of transaction.
Look not to the marketplace for explanation
but explain the marketplace itself
Einsenstein’s four functions of print
Dissemination, standardisation, reorganisation, preservation
Johns challenge to Einsenstein
Anti-standardisation- print culture gives people options, brings disillusion and confusion.
Problem of books as sources
we know what people read, but we don’t know what they though- reading an interpretive act.
Reformation
Images and texts as a source of anxiety- print as a problem
Descartes challenge to Harvey’s experimentation
Have no principle- experiments can’t contradict theory: evidence of a flawed experiment, not a flawed theory.
Sex as a cultural creation
Everything scientific is a social construct- biology of sex is included in this
readers of Vesalius who go immediately to chapters on sex
estimated 30% -censorship
Foreign bodies
relationship between body and state- concerns about meeting/mating and resulting diseased/corrupted bodies.
Race as defined by
anatomy- an evoliving, fluid concept.
Climate theory:
people moving around the world could ‘change race’ -> complicated by slavery and ease of travel, bodies became more fixe categories- race independent of climate.
What caused the collapse of pre-columbian America
new diseases they don’t have immunity to
Theory of race worried about
the degeneration of the body politic- anatomy and medicine tools of justification for racial categories.
Spaces that could be medicalised
- anatomy theatres
- hospitals
- cordon sanitaire
- mortality tables
Anatomy Theatres
- EMP invention
- Problematic dissection
- Anatomy as moving from butchery to an elite public spectacle
- Dissection = social rejection.
Foucault on hospitals
disciplinary spaces where the state exercises power over non-conforming bodies- 1675-1724 France: confinement as state policy for those refusing to adapt to polite life.
What are hospitals specifically designed for?
Air circulation.
Cordon Sanitaire
- roping off an area for health reasons
- Disease as an administrative responsibility
- Diseases which threatened the body politic- concerns for the health of the whole community
- Body health key for state administration
- medicine as part of the EM state development
Drug advertising 1670-1680
6x increase [Hill Curth]
Drugs and advertising
- info about the remedy with no face to face encounter
- Physicians and epistolary cures
- Long distance treatment-absence of the body
- Quality, effect, manner of use conveyed in print
- Way of reaching new consumers
Why doesn’t advertising fit well with Galenic models
Galenic- body as individual
Drug advertising- bodies as collective
At odds with the notion that you spend your life attending to health- instead buy a pill and get cured
Types of printed advertisement
Almanacs Newspapers Trade cards Handbills Broadsides Posters
Charlatans
- Universally targeted by physicians and other licensed practitioners
- Not a cohesive group with a collective identity
- A derogatory term
- Practiced medicine alone, not as a guilt
- No formal training
- Lacked theoretical underpinning to medical claims
What did charlatans offer?
specifics (treated symptoms of one disease) or panaceas (treated all diseases)
Successful remedies and counterfeits
Bateman’s scurvy grass- advertised 1680-1700 151 times- followed up by other scurvy grass products once established as successful
Apothecaries
- trained by apprenticeship
- regulated by guilds and physicians (could be inspected)
Irregular medical practitioners
- unregulated
- offered cures
Midwives
- regulated by ecclesiastical church courts
- Don’t fall within the hierarachy of medical practice
- Birth not a medical event unless it went wrong.
Medical Marketplace model
- Reduces medicine to an economic transaction
- No room for women/remedies/charitable/lay healing
- Monetises object of enquiry
- Patient agency- allows us to see full range of medical activities
- How occupation is defined
- Driven by patient as consumer
Centre-periphery model
- Brockliss and Jones
- trained medical practitioners centre, everyone else periphery
- Model defined in terms of power relations, legitimate vs. illegitimate
- Power dynamics between practitioners considered
Medical pluralism model
- healer and disease categories
- venn diagram: medical, popular, ecclesiastical
- Gentilcore- Naples - Catholic country
Nutton ‘Seeds of Disease’
Galen had indeed written of the possibility of seeds of disease, a view which suggested a belief in the contagious nature of some diseases, in such tracts as On initial causes, On the different types of fever, and in his commentary on the first book of the Epidemics.
Galen’s ‘seeds’ were intended to explain why some people contracted a particular disease while others escaped and he located them within the body
Overshadowed by humoral theory
Define early modern medicine
a diverse, pluralistic increasingly commercialized system, rather than a static hierarchy of care.
Paul Slack printed medical books
‘played no major factor in the provision of medical knowledge and treatment’
Exploration of wider print culture dismisses book-centric conclusion.
