History of Medicine
2012-2013 History of Medicine Speaker Series
PhD, Johns Hopkins University, Institute for the History of Medicine
"From Medical Eugenics to Genomic Medicine: The Relief of Suffering and the Self-Direction of Human Evolution."details
Lisa Lavine Nagy
MD, Medical Director: Vineyard Personalized Medicine (Vineyard Haven, MA)
“What Really Causes Illness?: The role of Environmental Medicine in the Future of Health Care.” details
Healing traditions have been part of all human societies. History shows us both the timelessness of birth and death, sickness and recovery, and dramatic changes in these elemental human experiences.
Tracing the history of medical knowledge, including medicines and tools, can help us to understand the origins of contemporary medical practice and the roads not taken, or retreated from. It can help us to understand medicine’s successes, which can brings us prevention of illness, cure from disease, and longer life. Through historical perspectives we are reminded of the health hazards faced by our predecessors—such as the high costs in money, lives, and disability of diseases such as diphtheria, measles, and polio before vaccines were invented. We can also see that the dilemmas of end-of-life care were apparent from the first introduction of advanced technologies such as the mechanical ventilator.
Many ancient medicines are still in use in one form or other. For example, plant-based medicines formed the basis for many modern pharmaceuticals, such as the knowledge that willow bark tea reduced fevers, which led to the development by Bayer of acetylsalycilic acid in 1899, also known as aspirin. A collaboration between Chinese doctors at the Peking Union Medical College, a pharmacologist from the University of Pennsylvania, and Eli Lilly brought the active ingredient from Ma huang, known to ease breathing, to the rest of the world as ephedrine. The first vaccines take their name from the Vaccinia virus (vaca standing for cow), adapted for deliberate vaccination when British physician Edward Jenner learned from a milk-maid that she was immune to smallpox—disfiguring and often fatal—because she had had the cowpox.
The history of medicine can give us new respect for the achievements of medicine in areas such as infectious diseases, cancer care, and cardiovascular intervention, reminding us what our lives might be like without these discoveries. From 1900 to 1999, life spans increased in the First World by three decades, from 47.3 to the 77 (1), and infant mortality fell from 100 infants per 1000 live births to 7.2 per 1000.(2) At other times new medical practices improve or extend life but stop short of cure, such as insulin or kidney dialysis, leading recipients to new regimens of dependence on technology. These and other cases show that dilemmas such as fair distribution of health care and questions about the goals of end-of-life care go hand in hand with medical progress.
The history of health care systems is perhaps even more revealing, showing how the United Kingdom’s National Health Service arose from the experience of World War II and the Swiss system of insurance from traditions of mutual aid within cantonments (local governing units). Meanwhile, the United States created a system of employer-based health insurance for workers and their families, social insurance for the elderly and work-disabled (Medicare), charitable or welfare insurance for the poor and congenitally disabled (Medicaid), a government owned and run system of hospitals and clinics for military veterans, and municipal and charitable hospitals for those left out. Who would design such a system? No one. Each element was a response to a particular problem or group of problems, from World War II caps on wages that led employers to lure workers with benefits such as health insurance, to the creation of Medicare in 1965 in response to the needs of the growing elderly population, the existence of new treatments that could improve or extend their lives, and the inability of many to pay for them because the 20th century invention of “retirement” had removed the elderly from the work force and hence the employer-based health insurance system.
It was not until medicine could make an obvious life and death difference that the demand for medical care became a moral imperative and a political demand. By the first decades of the twentieth century, the value of medical care was evident in vaccines and antitoxins which prevented childhood illnesses, medicines such as insulin which saved and extended life, and surgery which could cure dozens of conditions, aided by effective anesthesia and the protection of aseptic techniques. It was at that point that reformers sought to extend the reach of professional medical attention to the entire population for the first time. International comparisons in rates of illness and death, which became possible with the standardization of vital statistics reporting, again emphasized the dramatic differences in both overall death rates and in deaths from specific causes as a result of public health improvements and medical care.
As we continue to develop new medicines and technologies for diagnosis and treatment, understanding where we came from remains critical to decisions about not just where we can but where we should go with new medical technologies.
History of Medicine at Stony Brook
History of medicine has been part of both Medical Humanities at Stony Brook University Medical Center and the Department of History in the College of Arts & Sciences for more than three decades. The history of medicine has long been part of Stony Brook’s program in Medicine in Contemporary Society, and electives in the history of medicine are offered for 2nd and 4th year medical students. Founded by Barry S. Coller, MD and Ira Rezak, MD, Stony Brook University has hosted a lecture series in the history of medicine since 1978, bringing leading scholars in the history of medicine. The Department of History at Stony Brook has several distinguished historians of medicine on its faculty and offers courses in the history of medicine to undergraduates and graduate students.
The New York area is host to many of the country’s earliest medical institutions (along with Boston and Philadelphia) and as such also houses some of its best medical libraries of 18th, 19th and 20th century medical journals, books, pamphlets and illustrations. For example, Bellevue Hospital, New York, was founded in 1736 as the first municipal hospital in the country (Philadelphia’s Pennsylvania Hospital was founded in 1751 by a group including Benjamin Franklin, and Boston’s Massachusetts General was founded in 1811). For more information see the related links.