James C Whorton
Survey of evolution of medical theory, practice, and institutions in European and American society from the late 18th century to the present. Medical background not required. Recommended: prior courses in sciences and/or history.
This class will examine the evolution of medical theory, practice, and institutions in European and American society from antiquity to the present, concentrating on the last two centuries. The goal of the course is to provide students with an appreciation of the scientific and cultural forces that have created modern medicine, thereby establishing an historical perspective on the challenges and problems that confront American medicine at the beginning of the twenty-first century. This class will examine the evolution of medical theory, practice, and institutions in European and American society from antiquity to the present, concentrating on the last two centuries. The goal of the course is to provide students with an appreciation of the scientific and cultural forces that have created modern medicine, thereby establishing an historical perspective on the challenges and problems that confront American medicine at the beginning of the twenty-first century.
Student learning goals
General method of instruction
Instruction will be accomplished through informal lecture and discussion, backed by reading in original sources. Medical training is not a prerequisite, and previous college courses in the sciences or history are not essential.
Class assignments and grading
COURSE OUTLINE I. Medicine to 1800 A. Examination and Diagnosis (Hippocrates, Epidemics) B. Therapy (Craik and Dick, “George Washington’s Final Illness”) C. Theory and Philosophy
II. Surgery to 1800
A. Limitations of Surgery B. Empirical Improvements (Pare, Travels in Diverse Places) C. John Hunter and Experimentation D. Ephraim McDowell and Ovariotomy (McDowell, “Three Cases of Extirpation of Diseased Ovaria”)
III. Medicine in the Nineteenth Century
A Clinical Medicine: The Paris School 1. Rejection of systematic medicine and theory 2. Giovanni Morgagni and pathological anatomy: new interpretations of disease (Morgagni, On the Seats and Causes of Diseases) 3. Rene Laennec and the stethoscope: new methods of diagnosis (Laennec, Treatise on Mediate Oscultation) 4. Pierre Louis and the numerical method: new attitudes toward therapy (Holmes, “Currents and Counter-Currents”) (Davis, “Nature and Art”) 5. Nature vs. Art: the appearance of “irregular medicine” (Thomson, New Guide to Health) B. Experimental Medicine: Expansion of Medical Science 1. William Beaumont and physiology (Beaumont, Experiments and Observations) 2. Rudolph Virchow and cellular pathology 3. Louis Pasteur, Robert Koch and the development of germ theory (Koch, “On the Etiology of Tuberculosis”)
IV. Surgery in the Nineteenth Century
A. Discovery of Anesthesia (Morton, Remarks on the Proper Mode of Administering Sulphuric Ether) B. Discovery of the Physician as Agent of Infection 1. Ignac Semmelweis and puerperal fever (Semmelweis, The Concept of Childbed Fever) 2. Joseph Lister and Surgical Antisepsis (Lister, “On the Antiseptic Principle of the Practice of Surgery” ) 3. William Halsted and surgical asepsis
V. The Twentieth Century
A. Germs and Drugs 1. Purification of drugs 2. Synthesis of drugs 3. Paul Ehrlich and chemotherapy (Ehrlich, “Address Delivered at the Georg-Speyer Haus”) 4. The sulfa drugs B. Technology, Specialization, and the Modernization of the Hospital C. Florence Nightingale and the Professionalization of Nursing (Nightingale, Notes on Nursing) (Rideing, “Hospital Life in New York”) D. Reform of Medical Education 1. Medical education through the nineteenth century (Blackwell, Pioneer Work for Women) (Williams, “A Dissertation on ‘Female Physicians’”) 2. Abraham Flexner and the Flexner Report (Flexner, Medical Education in the United States and Canada) E. “Scientific Medicine” 1. Antibiotics 2. Organ transplantation F. “Diseases of Medical Progress” 1. Adverse drug reactions 2. Doctor-patient relations 3. Costs of medical care 4. Ethical dilemmas
Grades will be based on performance on two exams, one covering the first half of the course, the other the second half.
Each exam will require you to clearly identify a number of items such as people, books, theories, and drugs. Exam instructions will be:
Identify each of the following items by explaining who or what it was, when it was (to the nearest third of a century), and what significance it had for the history of medical thought and/or practice. For each non-person item identify the person most closely associated with it (its discoverer, developer, author), and include nationality for each person identified.
An exam can be rescheduled due to illness or other personal problem, but do not ask to take an exam on a different day because you have another exam on the scheduled date, as rescheduling your exam would not be fair to other students who also have other exams that date.
Extra-credit projects are not an option.