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Approaches to the History of Medicine: Discussing Methodology

Conference Report

Despite gales playing havoc with the transport network, twenty scholars made it to Warwick on 19 January 2007 for an informal workshop to explore methodological approaches to the history of medicine. The organisers had felt there was a need for an event exploring new approaches to medical history as a discipline, rather than one organised by a thematic agenda. In particular, the day was aimed at providing academics in the early stages of their careers the opportunity to work through queries and explore a range of debates. Four invited speakers led the sessions.

The day was started by David Arnold, who recently joined Warwick from SOAS. Professor Arnold revisited his own major work Colonizing the Body, and explored wider debates surrounding colonial bodies, medicine and control, as well as positioning his own current work within a wider emergent interest in the 'global'. Initial discussion questioned the claims to universality of 'western' medicine, with Professor Arnold suggesting that these were implicit as early as the seventeenth century in the writings of travellers. It was asked whether former colonies were re-evaluating their own place within colonial medical systems, and whether 'colonies' are insufficient areas of debate. Should we be considering shared regional experiences, for example, across south and east Asia? Amongst the themes that emerged clearly in this session, was the centrality of conflict in the history of the colonised body, a theme that re-emerged throughout the day.

Claudia Stein's exploration of approaches to disease reflected her own diverse research interests, from the French pox to AIDS, and the varying ways in which diseases can be explored historically, from paleopathology, through social construction and Bruno Latour's questioning of the diagnosis of tuberculosis in Ramses II, to Rosenberg's 'framing' and Sontag's 'illness as metaphor'. Stein's talk raised many important questions, including whether a current disease such as AIDS should be considered the same disease, or indeed treated in the same way, in South Africa and Britain. Further questions again raised the question of conflict, and whether resistance is inbuilt to any given episteme. Explicit in Dr Stein's discussion of approaches to disease was the need for historians to choose a concept or theory reflecting their own world-view.

Medical geography, argued Birmingham University's Jonathan Reinarz, is the key to transcending traditional thematic barriers within the discipline. Historians have generally regarded science and medicine as 'placeless', however, it was concluded that medicine is most certainly dependent on the place in which it is conducted. Dr Reinarz urged a return to local history and reviewed works by Cresswell, Livingstone, Naylor and Warner, who have used medical geography to demonstrate the interconnectivity of scientific and medical history. The session reviewed the Foucauldian concept of 'spatial nomadism', and opted in favour of Chris Philo's 'spatial precision' as a concept requiring more attention from scholars. Colonial medical historians have traditionally been conscious of place as a key factor in writing history, and the links between Professor David Arnold's presentation in the morning were capitalised and expanded upon. It was suggested that only through an increased awareness of medical geography can scholars in the discipline hope to 'synthesise the disparate micro-studies' that have been written, and move forward with productive, comparative analysis of hospitals, cities, countries and regions.

The final session of the day was conducted by Flurin Condrau from Manchester. Building on themes explored by the previous speakers, Dr Condrau examined the historiography of the 'view from below' and raised a heated debate on the feasibility and productivity of attempting this type of history. Where is the patient in medical history and did he/she even exist before bioscience invented the concept of the 'patient'? After examining cultural and social approaches to conducting history from below, Dr Condrau suggested the importance, especially in late nineteenth and early twentieth century medical history, of taking into account the politics of medicine. Patients and power relations in modern history are an important vehicle for understanding policy development and implementation. There is undeniably a problem of sources and bias in writing the history from below, but it was largely agreed that the benefits of such an approach far outweighed the drawbacks.

The level of debate and participation throughout the workshop confirmed the need for further conversation between widely divergent interests all focused on the uniting principle of health, its importance in the past and relevance in and around the world today. The organisers would like to acknowledge the support of the Wellcome Trust in providing funding through the Centre for the History of Medicine's Strategic Award, all the attendees, and in particular the speakers for providing four completely different, but equally impassioned and enthusiastic discussions about what constitutes, and is important in, the history of medicine.

Lisa Grant & Kat Foxhall