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In the first half of this century, Henry Ernest Sigerist was widely regarded as the world's leading historian of medicine. A brilliant teacher and lecturer, Sigerist made medical history exciting and relevant for a whole generation of young physicians, medical students, historians, and the general public. A Marxist sympathizer and advocate of socialized medicine, he also had an enormous and controversial influence on the medical politics of his time. In Making Medical History historians Elizabeth Fee and Theodore M. Brown bring together individuals from various disciplines, many of whom knew Henry Sigerist, all of whom help to illuminate why, thirty-five years after his death, he continues to be revered by many public health professionals and medical historians. Sigerist came to the Johns Hopkins Institute of the History of Medicine in 1932, arriving from Leipzig to succeed William Henry Welch as director. During Sigerist's tenure at Hopkins, his many accomplishments included founding the leading scholarly journal in the field, the Bulletin of the History of Medicine; transforming the American Association for the History of Medicine into a professional organization; and recruiting and mentoring such luminaries as Owsei Temkin, Ludwig Edelstein, and Erwin Ackerknecht. Organized into three main sections--biographical, historiographical, and political--Making Medical History includes discussions of Sigerist's influence on the history of medicine, medical sociology, and health policy. Today, as the American health care system undergoes tremendous structural changes, Sigerist's work and vision are newly relevant, and his dramatically effective presentation of medical history willcome as a revelation to a new generation of readers. Contributors: Nora Sigerist Beeson, Marcel H. Bickel, Theodore M. Brown, Leslie A. Falk, Elizabeth Fee, John F. Hutchinson, Ingrid Kstner, Walter J. Lear, Michael R. McVaugh, Genevieve Miller, Milton I. Roemer, Owsei Temkin, Ilza Veith, and Heinrich von Staden.
"With diverse constitutions, a multiplicity of approaches, styles, and aims is both expected and desired. This volume locates medical history within itself and within larger historiographic trends, providing a springboard for discussions about what the history of medicine should be, and what aims it should serve."--Jacket
An eye-opening exploration of the medical origins of gender in modern US history. Today, a world without “gender” is hard to imagine. Gender is at the center of contentious political and social debates, shapes policy decisions, and informs our everyday lives. Its formulation, however, is lesser known: Gender was first used in clinical practice. This book tells the story of the invention of gender in American medicine, detailing how it was shaped by mid-twentieth-century American notions of culture, personality, and social engineering. Sandra Eder shows how the concept of gender transformed from a pragmatic tool in the sex assignment of children with intersex traits in the 1950s to an essential category in clinics for transgender individuals in the 1960s. Following gender outside the clinic, she reconstructs the variable ways feminists integrated gender into their theories and practices in the 1970s. The process by which ideas about gender became medicalized, enforced, and popularized was messy, and the route by which gender came to be understood and applied through the treatment of patients with intersex traits was fraught and contested. In historicizing the emergence of the sex/gender binary, Eder reveals the role of medical practice in developing a transformative idea and the interdependence between practice and wider social norms that inform the attitudes of physicians and researchers. She shows that ideas like gender can take on a life of their own and may be used to question the normative perceptions they were based on. Illuminating and deeply researched, the book closes a notable gap in the history of gender and will inspire current debates on the relationship between social norms and medical practice.
How is medical knowledge made? New methods for research and clinical care have reshaped the practices of medical knowledge production over the last forty years. Consensus conferences, evidence-based medicine, translational medicine, and narrative medicine are among the most prominent new methods. Making Medical Knowledge explores their origins and aims, their epistemic strengths, and their epistemic weaknesses. Miriam Solomon argues that the familiar dichotomy between the art and the science of medicine is not adequate for understanding this plurality of methods. The book begins by tracing the development of medical consensus conferences, from their beginning at the United States' National Institutes of Health in 1977, to their widespread adoption in national and international contexts. It discusses consensus conferences as social epistemic institutions designed to embody democracy and achieve objectivity. Evidence-based medicine, which developed next, ranks expert consensus at the bottom of the evidence hierarchy, thus challenging the authority of consensus conferences. Evidence-based medicine has transformed both medical research and clinical medicine in many positive ways, but it has also been accused of creating an intellectual hegemony that has marginalized crucial stages of scientific research, particularly scientific discovery. Translational medicine is understood as a response to the shortfalls of both consensus conferences and evidence-based medicine. Narrative medicine is the most prominent recent development in the medical humanities. Its central claim is that attention to narrative is essential for patient care. Solomon argues that the differences between narrative medicine and the other methods have been exaggerated, and offers a pluralistic account of how the all the methods interact and sometimes conflict. The result is both practical and theoretical suggestions for how to improve medical knowledge and understand medical controversies.
The definitive evidence-based introduction to patient history-taking NOW IN FULL COLOR For medical students and other health professions students, an accurate differential diagnosis starts with The Patient History. The ideal companion to major textbooks on the physical examination, this trusted guide is widely acclaimed for its skill-building, and evidence based approach to the medical history. Now in full color, The Patient History defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. The second edition features all-new chapters, case scenarios, and a wealth of diagnostic algorithms. Introductory chapters articulate the fundamental principles of medical interviewing. The book employs a rigorous evidenced-based approach, reviewing and highlighting relevant citations from the literature throughout each chapter. Features NEW! Case scenarios introduce each chapter and place history-taking principles in clinical context NEW! Self-assessment multiple choice Q&A conclude each chapter—an ideal review for students seeking to assess their retention of chapter material NEW! Full-color presentation Essential chapter on red eye, pruritus, and hair loss Symptom-based chapters covering 59 common symptoms and clinical presentations Diagnostic approach section after each chapter featuring color algorithms and several multiple-choice questions Hundreds of practical, high-yield questions to guide the history, ranging from basic queries to those appropriate for more experienced clinicians
At the dawn of the twenty-first century, we have become accustomed to medical breakthroughs and conditioned to assume that, regardless of illnesses, doctors almost certainly will be able to help—not just by diagnosing us and alleviating our pain, but by actually treating or even curing diseases, and significantly improving our lives. For most of human history, however, that was far from the case, as veteran medical historian Michael Bliss explains in The Making of Modern Medicine. Focusing on a few key moments in the transformation of medical care, Bliss reveals the way that new discoveries and new approaches led doctors and patients alike to discard fatalism and their traditional religious acceptance of suffering in favor of a new faith in health care and in the capacity of doctors to treat disease. He takes readers in his account to three turning points—a devastating smallpox outbreak in Montreal in 1885, the founding of the Johns Hopkins Hospital and Medical School, and the discovery of insulin—and recounts the lives of three crucial figures—researcher Frederick Banting, surgeon Harvey Cushing, and physician William Osler—turning medical history into a fascinating story of dedication and discovery. Compact and compelling, this searching history vividly depicts and explains the emergence of modern medicine—and, in a provocative epilogue, outlines the paradoxes and confusions underlying our contemporary understanding of disease, death, and life itself.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
In 1748, as yellow fever raged in Charleston, South Carolina, doctor John Lining remarked, "There is something very singular in the constitution of the Negroes, which renders them not liable to this fever." Lining's comments presaged ideas about blackness that would endure in medical discourses and beyond. In this fascinating medical history, Rana A. Hogarth examines the creation and circulation of medical ideas about blackness in the Atlantic World during the late eighteenth and early nineteenth centuries. She shows how white physicians deployed blackness as a medically significant marker of difference and used medical knowledge to improve plantation labor efficiency, safeguard colonial and civic interests, and enhance control over black bodies during the era of slavery. Hogarth refigures Atlantic slave societies as medical frontiers of knowledge production on the topic of racial difference. Rather than looking to their counterparts in Europe who collected and dissected bodies to gain knowledge about race, white physicians in Atlantic slaveholding regions created and tested ideas about race based on the contexts in which they lived and practiced. What emerges in sharp relief is the ways in which blackness was reified in medical discourses and used to perpetuate notions of white supremacy.