HIST 126 01 / HSHM 223 01 (S16)

HSHM223/Hist126
DoctorsandPatientsinWesternMedicine

Spring 2016

LC 317

MW 1:30-2:20

Courtney Thompson

Lecturer, Program in the History of Science and Medicine

Yale University

Courtney.thompson@yale.edu

Office Hours: by appointment

COURSEDESCRIPTION:

This course examines the history of western medicine with particular attention to the place of doctors and patients and the
doctor/patient encounter within the history of medicine. Students will be introduced to major themes, figures, and developments
in the history of medicine in Europe and America, as well as close examinations of the roles of different kinds of practitioners and
the experiences of patients in the therapeutic encounter.

Each week students will read primary sources to complement course lectures, and they will discuss these readings in discussion
sections. Students will be responsible for participation in section discussion and activities. Evaluation will be based on two short
papers and two exams, in addition to section participation.

READINGS:

We will be using the following text as the primary sourcebook (the readings are listed as M&WC in the course schedule):

David J. Rothman, Stephen Marcus, and Stephanie A. Kiceluk, eds. Medicine and Western Civilization New Brunswick,
NJ: Rutgers University Press, 1995. ISBN-13: 978-0813521909.

You must have a copy of this book for class; copies are available at the Yale Bookstore, or you can order them independently.
Other readings will be available on the course website.

EVALUATION:

Evaluation will be based on participation in discussion sections, a midterm exam, a final exam, and a paper.

Attendance and participation in class discussion: 15%

Opinion piece: 15%

Midterm: 20%

Paper: 20%

Final exam: 30%

Classparticipationandattendance (15%): Students are required to attend all section meetings, and they must come
prepared for enthusiastic discussion. Attendance will not be taken for lecture meetings, but you will be responsible for getting
notes for the material you missed: your instructor and teaching fellows are not responsible for making up your missed lectures,
and the exams will be substantially based on lecture material. Slides will be available on the course website.

Opinionpiece (15%): The opinion piece is a short essay (3-5 pgs.) written in the style of an op-ed essay or article, such as one
would see in the New York Times, Washington Post, Slate, or another similar form of media. For this assignment, students will
be expected to write the op-ed from a historical point of view, using history to inform their analysis of a current event or debate.
Historical evidence and themes from the class must be incorporated into this assignment. The opinion piece will be due February
19.

Midterm (20%): The midterm will be focused on identification and short answer questions, with an essay component. The
midterm will be held on March 2.

Shortpaper(20%): The short paper (5-7 pgs.) will be a close analysis of a primary source or small set of sources. Students will
identify and analyze a primary source that either focuses on the experiences and perspective of a medical practitioner OR that of
a patient. The short analysis must have a clear argument that is supported by evidence and analysis drawn from the primary
source and strong contextualization, based on but not limited to course materials and themes. The short paper will be due April
29.

Finalexam (30%): The final exam will be cumulative, based on material from throughout the semester. The exam will consist of
identifications, short answers, and a substantial essay component.

Therewillbenoextensionsforanyoftheassignments.Nolateworkwillbeacceptedwithoutpenaltyunless
accompaniedbyaDeansExcuse.

Technologypolicy: Laptops may be used in lecture if used appropriately. If students begin regularly using their laptops for
purposes other than taking notes, I reserve the right to ban the use of laptops in lecture. Cell phones should be silenced and put
away for the duration of lecture.

Disabilityandaccommodations: If you are in need of disability-related accommodations or services, it is your responsibility

to contact the Resource Office on Disabilities in order to formally request accommodations. The Office will assist you in
preparing a Letter of Accommodations, which will serve as an action plan for you and your instructor. I encourage you to seek out
the Office and talk to your Dean if you are concerned about your ability to fulfill the expectations of the class; I am happy to work
with you individually, but official accommodations through the Office on Disabilities will be the most helpful way for you to have
a successful semester. The accommodations process is entirely confidential. Please talk to me if you have questions or concerns.
For more information see: http://yalecollege.yale.edu/student-services/resource-office-disabilities/student-information.

Academicdishonesty: There are many forms of academic dishonesty and plagiarism. Some of these include: turning in
someone elses work as your own; handing in the same paper for two different courses without the express permission of the
instructors of both courses; cheating on a test, exam, or any other assignment; incorrectly citing sources or falsifying information
and/or sources; forging a Deans excuse; etc. We will address plagiarism and correct use of sources during the semester. For
more information see: http://yalecollege.yale.edu/content/cheating-plagiarism-and-documentation.

COURSESCHEDULE

WEEK1:TheOriginsofWesternMedicine

What are the major themes and questions in the history of medicine? What are the origins of the doctor-patient relationship?
Where did the Hippocratic oath come from? What were the foundational theories and therapies for Ancient medicine, and how
long did they continue to influence Western medicine into the modern period?

Lecture 1 (January 20): Introduction to the History of Medicine

Lecture 2 (January 22): Medicine and the Ancient World

Readings:

Galen, The Hand (M&WC, 17-22).

Hippocrates, The Nature of Man; The Sacred Disease; The Hippocratic Oath (M&WC 43-47; 139-144; 261-262).

Aristotle, The Generation of Animals (M&WC 79-83).

WEEK2:MedievalandEarlyModernMedicine

What was medicine like in the dark ages? What happened to Greek and Roman medical traditions? How did the medical
profession(s) come into being in the early modern period?

Lecture 3 (January 25): Medicine in the Middle Ages & the Birth of the Professions

January 27: NO LECTURE. Class will not meet.

Readings:

Battista Piergilius, The Life of Sister Chiara of Montefalco (M&WC 37-40).

Jordan of Turre, The Symptons of Lepers (M&WC 209-211).

Arnald of Villanova, On the Precautions That Physicians Must Observe (M&WC 269-273).

Heinrich Kramer and James Sprenger, Malleus Maleficarum (M&WC 84-88).

Ulrich von Hutten, Of the Beginning of the French Pox, and the Several Names by Which It Has been Called (M&WC
212-216).

WEEK3:TheEarlyModernBody

What was the anatomical renaissance and how influential was it? How did scholars understand the body in the early modern
period, and how did patients understand their bodies? What is the difference between theory and practice?

Lecture 4 (February 1): The Anatomical Renaissance

Lecture 5 (February 3): Visualizing the Early Modern Body in the Early Modern World

Readings:

Andreas Vesalius, The Fabric of the Human Body; Baldasar Heseler, Andreas Vesalius First Public Anatomy at Bologna
(M&WC 54-65).

William Harvey An Anatomical Study on the Motion of the Heart and Blood in Animals (M&WC 68-78).

Felix Platter, Journal (M&WC 66-67).

Michel de Montaigne, On the Power of the Imagination (M&WC 152-158).

Edward Jenner, An Inquiry into the Causes and Effects of the Variolae Vaccine, or Cow-Pox(M&WC 299-309).

WEEK4:EnlightenmentandRevolutioninMedicine

What did the medical marketplace look like in the eighteenth century? What options were available for treatment? What changes
with the birth of the clinic, and what stays the same?

Lecture 6 (February 8): Quacks and Midwives

Lecture 7 (February 10): The Birth of the Clinic

Readings:

Laurel Thatcher Ulrich, Midwifes Tale. Chapter 5.

William Hunter, The Gravid Uterus (1774). Explore the plates here:

http://www.nlm.nih.gov/exhibition/historicalanatomies/hunterw_home.html
 R.T.H. Laennec, A Treatise on the Diseases of the Chest (M&WC 310-313).

Philippe Pinel, The Clinical Training of Doctors (M&WC 343-351).

WEEK5:BecomingaPhysicianintheNineteenthCentury

What was it like to be a physician in the nineteenth century? What was it like to experience heroic medicine as a patient? What
alternatives were there to orthodox medicine, and why would a patient have chosen unorthodox practitioners?

Lecture 8 (February 15): The Invention of Heroic Medicine

Lecture 9 (February 17): More than Physicians

Readings:

Benjamin Rush, The Vices and Virtues of Physicians (M&WC 278-281).

Elizabeth Blackwell, The Influence of Women in the Profession of Medicine (M&WC 282-287).

William Blanding, Diary (1807). Selections.

Walter Channing, Remarks on the Employment of Females as Practitioners in Midwifery (1820).

N. Williams, A Dissertation on Female Physicians. (1850).

Samuel Thomson, New Guide to Health (1822). Selections.

DUEDATE:Opedpaper,Friday,February19.

WEEK6:ModernityandMedicine

What does modernity mean for medicine what new challenges and solutions did the modern period present for physicians and
patients? How does medicine and public health change with the advent of germ theory?

Lecture 10 (February 22): Dirt, Disease, andTrains?

Lecture 11 (February 24): Germ Theory and the Laboratory

Readings:

Edwin Chadwick, Report on the Sanitary Condition of the Laboring Population of Great Britain (M&WC 217-239).

Herbert Page, Injuries of the Spine and Spinal Cord (1885). Selections.

Ignaz Semmelweis, The Etiology, Concept, ad Prophylaxis of Childbed Fever (M&WC 240-246).

Joseph Lister, On the Antiseptic Principle in the Practice of Surgery (M&WC 247-252).

Louis Pasteur, On the Extension of the Germ Theory to the Etiology of Certain Common Diseases (M&WC 253-257).

WEEK7:AGoldenAge?

Was there a golden age for medicine? How did bedside medicine and laboratory medicine come together at the end of the
nineteenth century, and what were the implications for patient care?

Lecture 12 (February 29): Scientific Medicine

MIDTERM (March 2)


Readings:

Henry P. Bowditch, Letters. (1869). Excerpts.

Clarence Blake, Letters (1869). Excerpts.

Roberts Bartholow, The Present State of Therapeutics (1879).

Daniel W. Cathell, The Physician Himself and What He Should Add to the Strictly Scientific (1882).

WEEK8:HealthatHomeandAbroad

How did germ theory influence daily life and social expectations about health and disease? How did western medicine translate
to colonial contexts and what new challenges were presented by tropical diseases?

Lecture 13 (March 7): The Gospel of Germs

Lecture 14 (March 9): Empire and Tropical Medicine

Readings:

Elmer Borland, Municipal Regulation of the Spitting Habit(1900).

Charles V. Chapin, "Dirt, Disease, and the Health Officer" (1903).

Terence V. Powderly, Immigrations Menace to the National Health (1902).

John E. Hunter, Tuberculosis in the Negro: Causes and Treatment (1905).

Patrick Manson,TropicalDiseases:AManualoftheDiseasesofWarmClimates(1898). Selections.

SPRINGBREAK

WEEK9:TwentiethcenturyMedicalRevolutions

How and why did medical education and health institutions change at the turn of the twentieth century? How does war affect
health and drive medical innovation?

Lecture 15 (March 28): Remaking Institutions of Health

Lecture 16 (March 30): War and Health

Readings:

Abraham Flexner, Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the
Advancement of Teaching (1910). Excerpts.

Isabella Vandervall, Some Problems of the Colored Woman Physician (1917).

John G. Bowman, Standard of Efficiency of the First Hospital Survey of the College (1918).

Army Alpha Test #8 for Recruits to the Military (1921).

George Orwell, How the Poor Die (M&WC 368-375).

W.H.R. Rivers, The Repression of War Experience (1918).

WEEK10:HealthandIdentityintheTwentiethCentury
How did scientific discussions about health and the body influence political, social, and religious debates about medicine and
public health? How is the health of the individual measured against the health of the body politic?

Lecture 17 (April 4): Eugenics, Health, and the Nation

Lecture 18 (April 6): The Politics of Vaccination

Readings:

Our Babies: A Talk with the Doctor (1920).

Children's Bureau Records (1916-1926).

Polio Pointers for Parents (1954).

Buckv.Bell(1924).

Margaret Sanger, "Birth Control and Racial Betterment" (1919).

Explore the primary sources of the Eugenicsarchive.org.

WEEK11:VulnerableBodies

What is the role of the patient in making knowledge about the body and disease? How did standards of patient consent emerge?
How do sociocultural and political pressures influence the standards for experimental protocol and healthcare?

Lecture 19 (April 11): Patients as Experimental Subjects

Lecture 20 (April 13): Patients as Activists

Readings:

Shimkin, "The Problems of Experiments on Human Beings" (1953).

Donald Rockwell et al., "The Tuskegee Study of Untreated Syphilis: The 30th Year of Observation" (1964).

Dr. Irwin Schatz to Dr. Donald Rockwell (11 June 1965).

Hearings before the Senate Subcommittee on Health: Quality of Health Care Human Experimentation (M&WC 330-
341).

Joseph Dimow, A Personal Account of the Milgram Obedience Experiments (2004).

Our Bodies, Ourselves (1971). Excerpts.

WEEK12:ThePoliticsofHealth

How does money affect medical outcomes and public health efforts? Who pays for medicine and why? What was the role of the
AIDS crisis in remaking public health and making health public?

Lecture 21 (April 18): Money and Medicine

Lecture 22 (April 20): The AIDS Experience

Readings:

Rashi Fein, Medical Care, Medical Costs (1999). Selections.

Stuart Chase and F. J. Schlink, Consumers in Wonderland, New Republic 49 (1927), 348-51
 Paul Monette, Borrowed Time: An AIDS Memoir (M&WC 426-433).

Additional readings TBA.

WEEK13:MedicalFutures

What are the trends in modern medicine, on a global scale and in terms of public profile? What does it mean to be a celebrity
doctor or patient? What is the utility of the patient memoir?

Lecture 23 (April 25): Doctors and Patients without Borders

Lecture 24 (April 27): Celebrity Medicine

Readings:

Atul Gawande, Better (2008). The Mop-Up.

Sara Lawrence Lightfoot, Balm in Gilead: Journey of a Healer (M&WC 290-295).

Jean Stafford, The Interior Castle (M&WC 406-416).

DUEDATE:Shortpaper,Friday,April29.

FINALEXAMDURINGEXAMPERIOD.

Doctors and Patients.pdf