History 66 --- Fall, 2010
Disease and Doctors
An Introduction to the History of Western Medicine
Professor John W. Servos
Books Recommended for Purchase
G. E. R. Lloyd, Hippocratic Writings (New York: Penguin, 1978)
Roy Porter, The Greatest Benefit of Mankind: A Medical History of Humanity (New York: Norton, 1997)
David Herlihy, The Black Death and the Transformation of the West (Cambridge, Mass: Harvard University Press,
1997)
Randy Shilts, And the Band Played On (New York: Penguin)
Jonathan Engel, The Epidemic: A Global History of AIDS (New York: Smithsonian Books, 2006)
Copies of the above should be available at Amherst Books and will be available for short-term borrow at the Reserve
Desk of Frost Library. Other readings will be available in multilith from the History Department office in Chapin
Hall.
Schedule of Papers, Readings, and Discussion Topics
Wed. 9/8
Introduction
Part I The Hippocratic/Galenic Tradition (The Origins of Western Medicine)
Mon. 9/13
Origins of Medicine
Roy Porter, The Greatest Benefit of Mankind, pp. 3-50.
E. H. Ackerknecht, "Typical Aspects of Primitive Medicine," in Medicine and Ethnology,
ed. H. H. Walser and H. M. Koelbing (Baltimore, 1971), pp. 17-29.
L. Pierce Williams and Henry John Steffens, eds., The History of Science in Western
Civilization, vol. 1, pp. 35-40 (excerpts from Egyptian and Babylonian medical texts).
Wed. 9/15
The School of Hippocrates
Porter, Greatest Benefit, pp. 50-66.
G. E. R. Lloyd, ed., Hippocratic Writings, pp. 237-251 (The Sacred Disease).
Mon. 9/20
Greek Medical Practice and Theory
G. E. R. Lloyd, ed., Hippocratic Writings, pp. 67, 148-169, and 260-271 (Oath, Airs,
Waters, Places, and The Nature of Man). Also read the first page of Prognosis (Lloyd,
ed., p. 170) and cases ii-v and ix-x from the Epidemics (Lloyd, ed., pp. 102-106 and 108109).
Testimonials from the Temple of Asclepias at Epidauros.
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Wed. 9/22
Galen
Porter, Greatest Benefit, pp. 66-82.
Galen, On the Sects for Beginners and selections from On Anatomical Procedures.
Clendening, ed., Source Book on Medical History, pp. 45-51 (other selections from
Galen).
Three page paper due (before class). Hippocrates and Galen enjoyed great fame and respect in
antiquity. Yet by modern standards their medicine was exceedingly feeble. Their theories were
highly speculative; their therapies, in general, were probably no more effective than those of the
temple priests and faith-healers whom they criticized. Why then did practitioners of Hippocratic
medicine succeed in developing a clientele? Please ground your response in evidence drawn from
the primary sources (e.g., the writings of Hippocrates and Galen and testimonials from Epidauros).
Mon. 9/27
The Transmission of Medical Learning to the Christian West
Porter, Greatest Benefit, pp. 83-112.
Edward Grant, ed., Source Book in Medieval Science (Cambridge: Harvard University
Press, 1974), pp. 700-704 (selections from Isidore of Seville, Etymologies).
Clendening, ed., Source Book on Medical History, pp. 71-75 (selections from Rhazes,
Treatise on the Smallpox and Measles).
Wed. 9/29
Academic Medicine: The Uses of Theory
Porter, Greatest Benefit, pp. 112-134.
Grant, ed., Source Book in Medieval Science, pp. 715-720 (selections from Avicenna,
Canon of Medicine).
Taddeo Alderotti, Questiones (typescript).
Mon. 10/4
Practical Doctoring
C. H. Talbot, Medicine in Medieval England, pp. 125-133 and 170-185.
Grant, ed., Source Book in Medieval Science, pp. 742-745 and 751-752 (selections from
Archimatthaeus, "General Instructions for the Practitioner" and Arnald of Villanova, "On
the Precautions that Physicians Must Observe").
Three page paper due. You have read several authors, including Avicenna and Galen, who
argue that theory is essential to medical education and practice. You have also seen some
documents pertinent to education (the Questiones of Alderotti, e.g.) and practice (case histories,
e.g.). Making use of these materials, please give me your views about why eminent teachers and
healers were so insistent about the value of theory. How, for example, might the humoral theory of
health and disease have helped a medical student? How might it have helped a teacher of
medicine? And how might it have assisted the physician as he made practical decisions about
treatment?
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Wed. 10/6
Responses to Medical Crisis: The Black Death
David Herlihy, The Black Death and the Transformation of the West, pp. 17-81.
William M. Bowsky, The Black Death: A Turning Point in History?, pp. 7-18 (selections
from the writings of 14th-century observers of the plague).
James S. Amelang, ed., A Journal of the Plague Year: The Diary of the Barcelona Tanner
Miquel Parets, 1651, pp. 59-68 and 74-75.
Mon. 10/11
Recess
Part II New Science and New Medicine, 16th-18th Centuries
Wed. 10/13
Morbid Anatomy and Surgery
Porter, Greatest Benefit, pp. 163-200.
Vesalius, Preface to On the Fabric of the Human Body (1543) in C. D. O'Malley, Andreas
Vesalius of Brussels, pp. 317-324.
Ambroise Paré, Apologie and Treatise, pp. 91-99; 146-160; 201-220.
Mon. 10/18
Paracelsus and the Paracelsians
Porter, Greatest Benefit, pp. 201-211.
Paracelsus, Selected Writings, pp. 3-9; 49-97.
Wed. 10/20
William Harvey
Porter, Greatest Benefit, pp. 211-244.
William Harvey, On the Motion of the Heart and Arteries, selections.
Two page paper due. Revolutionary changes occurred in anatomy and physiology during the
16th and 17th centuries. Paré=s textbook suggests that important progress also occurred in surgical
practices. What, if any, connections exist between the two developments? Would a surgeon as
experienced as Paré learn anything useful from the study of the anatomical work of Vesalius and
Harvey? If so, what? If not, why not?
Mon. 10/25
Medicine >Enlightened=
Porter, Greatest Benefit, pp. 245-303.
Part III The Medical Revolutions of the Nineteenth Century
Wed. 10/27
The Rise of the Clinic (From Humors to Lesions)
Porter, Greatest Benefit, pp. 304-347.
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Clendening, Source Book on Medical History, pp. 313-330 (selections from Laennec).
Mon. 11/1
Varieties of Response to Therapeutic Uncertainty
Porter, Greatest Benefit, pp. 348-396.
Jacob Bigelow, "On Self-Limited Diseases," (1835) in Medical America in the Nineteenth
Century, ed. G. H. Brieger (Johns Hopkins, 1972).
Edwin L. Godkin, "Orthopathy and Heteropathy," (1867) in ibid., pp. 75-83.
Two page paper due. You are a state legislator in mid-19th century America. Should medical
doctors be licensed by the state? What reasons do you have for your position?
Wed. 11/3
Medicine and Social Welfare: Public Health
Porter, Greatest Benefit, pp. 397-427.
Edwin Chadwick, Report on the Sanitary Condition of the Labouring Population of Great
Britain (1842), ed. M. W. Flinn, selections.
Judith Walzer Leavitt, Typhoid Mary, Captive to the Public=s Health, pp. 14-69.
Mon. 11/8
Epidemiology and Pathology on the Eve of the Germ Theory
Oliver Wendell Holmes, "The Contagiousness of Puerperal Fever" (1843), selections.
Wed. 11/10
The Advent of Bacteriology
Porter, Greatest Benefit, pp. 428-445.
Clendening, ed., Source Book in Medical History, pp. 610-621 and 392-406 (selections
from works of Joseph Lister and Robert Koch).
Louis Pasteur, AGerm Theory and Its Applications to Medicine and Surgery (1878), at
http://www.fordham.edu/halsall/mod/1878pasteur-germ.html
Mon. 11/15
The Effects of Bacteriology on Medicine
Porter, Greatest Benefit, pp. 445-492.
David M. Hughes, ATwenty-Five Years in Country Practice,@ in Readings in American
Health Care, ed. William G. Rothstein (Madison: University of Wisconsin Press, 1995),
pp. 3-9.
Part IV Contemporary Issues and Their Historical Antecedents
Wed. 11/17
The Origins of Modern Medical Education
Porter, Greatest Benefit, pp. 525-534.
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Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical
Education (Basic Books, 1985), pp. 9-20 and 166-206.
Abraham Flexner, Medical Education in the United States and Canada (1910), selections.
Two page paper due. Flexner believed in the value of "scientific medicine.@ The regimen of
basic and biomedical sciences that he prescribed is essentially the sequence of courses that medical
students take today. How did Flexner justify such lengthy and expensive training for physicians?
What are the strengths and weaknesses of his argument?
THANKSGIVING RECESS
Mon. 11/29
From Infectious to Chronic Diseases: Disease Patterns and Vital Statistics
Thomas McKeown, The Role of Medicine: Dream, Mirage, or Nemesis? (Princeton
University Press, 1979), pp. xi-xvi and 3-116.
Wed. 12/1
Science, Specialization, and Patient Care
David J. Rothman, Strangers at the Bedside, pp. 70-81 and 127-140.
Stanley Joel Reiser, Medicine and the Reign of Technology, pp. 158-195.
Bernard Barber, "The Ethics of Experimentation with Human Subjects," Scientific
American 234 (1976): 25-31; reprinted in Stanley Joel Reiser, Arthur J. Dyck, and
William J. Curran, eds., Ethics in Medicine, pp. 322-328.
Mon. 12/6
Allocating Health Care
Paul Starr, "Transformation in Defeat: The Changing Objectives of National Health
Insurance, 1915-1980," in Ronald L. Numbers, ed., Compulsory Health Insurance: The
Continuing American Debate (Greenwood Press, 1982), pp. 115-143.
Kenneth M. Ludmerer, Time to Heal: American Medical Education from the Turn of the
Century to the Era of Managed Care (Oxford: Oxford University Press, 1999), pp. xxiixxvi.
Philip Rhodes, "Ethics and Private Medicine," in Callahan and Dunstan, eds., Biomedical
Ethics: An Anglo-American Dialogue, pp. 104-110.
James F. Childress, "Who Shall Live When Not All Can Live," in Reiser, Dyck, and
Curran, eds., Ethics in Medicine, pp. 620-626.
Wed. 12/8
AIDS
Randy Shilts, And the Band Played On: Politics, People and the AIDS Epidemic, pp. xxixxiii; 34-40; 47-50; 54-56; 61-69; 80-88; 93-99; 102-107; 115-116; 125-136; 160-161;
167-175; 189-191; 206-207; 219-226; 229; 242-243; 269-273; 299-301; 303-309; 314320; 339-347; 366-368; 371-372; 384-388; 409-411; 413-418; 429-438; 440-443; 450453; 457-463; 477-482; 489-491; 495-497; 507-516; 524-527; 539-543; 551-555; 559560; 575-580; 585-593.
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Mon. 12/13
Another Perspective on AIDS
Jonathan Engel, The Epidemic: A Global History of AIDS, pp. 1-102; 193-210; 321-326.
Wed. 12/15
SIX PAGE PAPER DUE