Experiencing Madness: Mental Patients in Medieval Arabo-Islamic Medicine.

This paper focuses on the mental patients in Arabo-Islamic Middle Ages. Patients suffering from mental illnesses generated a lot of interest for Arabo-Islamic physicians. The first objective of this study is to identify who were the mentally infirm and to compare the Arab physicians' typologies of mental patients to that of their Greek predecessors. The second part of this paper shifts the focus from theoretical descriptions to case histories and biographical sources, in order to understand how the physicians treated their mental patients, and to find out what was the social impact of this medical approach. Finally, because the special provision for the insane is a distinctive feature of the Islamic hospital, the third part of my paper examines whether the main purpose of these hospitals was the patients' confinement or their treatment.

Interpretations of the Healer's Touch in the Hippocratic Corpus.

This paper analyses gender as an aspect of the role of touch in the relationship between doctors and patients, as represented in the Hippocratic Corpus. Touch is an essential aspect of the ancient doctor's art, but one potentially fraught with concerns over gender: while seeing, hearing, and smelling are also central to the medical encounter, touching is the act that places the greatest demands on the privacy and bodily integrity of the patient. This paper shows--perhaps counterintuitively--that, despite the multiple assertions of gender differences put forward by the authors of the Hippocratic Corpus, these authors make little distinction between touching male and female patients. At the same time, the paper argues that ancient physicians were anxious to avoid the charge that they were harming their patients when they touched them. It demonstrates that male doctors, sensitive as they were to the problems posed by their interactions with female patients, were challenged in different ways when engaging in intimate contact with male patients.

Images of Doctors and their Implements: A Visual Dialogue between the Patient and the Doctor.

Images of physicians, patients, and medical instruments were placed on Graeco-Roman funerary monuments, altars and fresco paintings. These representations are examined here to determine whether there existed a standard convention by which physicians were depicted in order that the lay and possibly illiterate viewers could identify what the scene represented. Greek physicians were frequently shown with cupping vessels, midwives were seen with birthing stools, while Roman physicians were often shown with various surgical implements. It is argued that the correlation between the types of objects depicted with the medical practitioner was deliberately made by the artist to signify the nature of medicine the individual practiced, so that the viewer could identify the role the practitioner had in their society.

"It may not cure you, it may not save your life, but it will help you".

In the modern world, we are experiencing an epidemiological shift represented by the increasing prevalence of chronic diseases relative to that of acute diseases: more people are living longer, with more diseases, than ever before in human history. How are we to understand and to respond to this change? A study of provision of cancer treatment in Western Australia, especially among Indigenous populations, can illuminate ways in which healthcare providers and societies might better understand the treatment of chronic disease: healthcare providers should take care to appreciate patient perspectives and beliefs about disease aetiology and treatment. Consideration of treatment of disease in the ancient Graeco-Roman world supports the view that effective healing and maintenance of patient wellbeing occurs when healers communicate clearly with their patients about disease and treatment progression, and when healers are open-minded about patients' utilisation of multiple treatment modalities.

Approaches to the History of Patients: From the Ancient World to Early Modern Europe.

This chapter looks from an early modernist's perspective at some of the major questions and methodological issues that writing the history of patients in the ancient world shares with similar work on Patientengeschichte in medieval and early modern Europe. It addresses, in particular, the problem of finding adequate sources that give access to the patients' experience of illness and medicine and highlights the potential as well as the limitations of using physicians' case histories for that purpose. It discusses the doctor-patient relationship as it emerges from these sources, and the impact of the patient's point of view on learned medical theory and practice. In conclusion, it pleads for a cautious and nuanced approach to the controversial issue of retrospective diagnosis, recommending that historians consistently ask in which contexts and in what way the application of modern diagnostic labels to pre-modern accounts of illness can truly contribute to a better historical understanding rather than distort it.

On TB Vaccines, Patients' Demands, and Modern Printed Media in Times of Biomedical Uncertainties: Buenos Aires, 1920-1950.

Reconstructing some of the experiences of people living with tuberculosis in Argentina in the first half of the twentieth century, as reflected not only in written and oral accounts but also in individual and collective actions, this article explores the ways in which patients came to grips with medical expertise in times of biomedical uncertainty. These negotiations, which inevitably included adaptations as well as confrontations, highlight a much less passive and submissive patient-physician relationship than is often assumed. Though patients were certainly subordinate to medical doctors' knowledge and practices, that subordination, far from absolute, was limited and often overthrown. The article focuses on patients' demands to gain access to a vaccine not approved by the medical establishment. By engaging with media organizations, the sick invoked their "right to health" in order to obtain access to experimental treatments when biomedicine was unable to deliver efficient therapies.

Life satisfaction in chronic pain patients: the stress-buffering role of the centrality of religion.

Chronic pain (CP) is a stressful condition that severely impacts individuals' lives. Researchers have begun to explore the role of religion for CP patients, but the literature is scarce, especially for West European populations. Drawing from the transactional theory of stress, this study examined the associations between the religious meaning system and the life satisfaction for a group of CP patients who were members of a Flemish patients' association. To take into account the religious landscape of West European countries, the centrality of one's religious meaning system, rather than religious content, was the focus. Results from the questionnaires completed by 207 patients suggest that the centrality of a meaning system is an important factor in the promotion of life satisfaction for this group, above and beyond the influence of several control variables. Furthermore, the centrality of the religious meaning system moderated or buffered the detrimental influence of pain severity on life satisfaction.

[Appropriation of a healthcare space by a professional elite: physicians of the "Hospital Real" of Granada in the 16th century]. / La apropiación de un espacio asistencial por una élite profesional: los médicos del Hospital Real de Granada en el siglo XVI.

This study investigates the staffing by physicians of the "Hospital Real" in the city of Granada in the 16th century, focusing on the selection processes that preceded their respective and successive appointments. The aim is to illustrate the determination shown by this class of professionals to claim this healthcare space and the academic and socio-cultural requirements that they had to meet in return. These included the possession of a university degree and the accreditation of reputable surgical experience and, to a lesser degree, "limpieza de sangre" (proof of Spanish Christian ancestry) and the title of physician awarded by the local court of the Inquisition.

[Courses of cure: the case of French patients of Samuel and Melanie Hahnemann (1834-1868)]. / Behandlungsverläufe: Die französischen Patienten von Samuel und Mélanie Hahnemann (1834-1868).

Based on the letters sent by French patients to Hahnemann and his wife (or written about them), this essay focuses on the behaviour of patients towards treatment rather than on their representations and interpretations of illness and health. Despite the fact that we don't know exactly who the authors of these letters were, it is clear that they all hope to obtain some of Hahnemann's medicines. The well-known demand for medicine at the beginning of the 19th Century was reinforced by the mystery surrounding homeopathic remedies and the specific way they were made available. Relying on theories which lent an important role to the nerves and the patient's character to explain the origins of sickness, patients hoped that Hahnemann and his new doctrine would be able to change both their life and their psychical characteristics. One can conclude that for the authors of such letters, writing about illness could be a means to construct new behaviour patterns and new attitudes towards health and sickness, rather than an illustration of existing medical, social and literary models.

[The influence of changes in the human subjectivity concept of formation of physician-patient relations]. / Wplyw zmian koncepcji podmiotowosci czlowieka na ksztaltowanie sie relacji lekarz-pacjent.

Changes in the human subjectivity concept, expressing influences of cultural and outlook elements on formation of object of the European medicine, have so much affected evolution of the discipline, that it is currently directed to bring an image of a human body to anatomy, to treat a course of a disease in medical aspect and to give to diagnostic processes and therapy a character of means which can be verified in an empirical way. The changes are also reflected in a patient - physician relation, which develops in that time. A direct nature of contacts between the treated and the treating persons was taken as grounds of the relation. But reasons of the privileged position of therapists in comparison to patients have changed. The paper aims to show main trends in development of the patient -physician relationship and to represent the changing reasons for superiority of the treating persons who are in a therapeutic relation with a patient.

[Medical practice in Rome during the XVI century]. / La medicina a Roma nel secolo XVI. Malattie e medici di S. Filippo Neri.

S. Filippo Neri (1515-1595), founder of the Congregazione dell'Oratorio in Rome, was a longly debated clinic case for his various pathologies. Eminent scientists, like B. Eustachio and A. Cesalpino, treated him and drew up clinical reports, which were inserted in the Canonization Process and also published as scientific works, and which give useful informations about the history of medicine in the second half of the 16th century. Those reports relate, among others, about many diseases like frequent heart palpitation, shaking tremors heat flame and bronchitic fever episodes, that since hte age of thirty affected the saint. Autopsy revealed cardiac hypertrophia and pulmonary artery dilatation over twice the normal diameter. G. M. Lancisi was the first who formulated the hypothesis of an artery aneurysm, which, according to the present knowledge, can be produced by a post-stenotic dilatation of the pulmonary valve and/or pulmonary hypertension. Tremors and flames can be attributed to hyperthyroidism. Doctors who treated S. Filippo Neri and who shoved to be aware of his psychology, considered his pathology due to supernatural causes. Their conclusions can be understood basing on the medical way of thinking of that age, which was still linked to ancient medicine and limited by the biological and medical knowledge of the time.

Malignant histories: Psychosomatic medicine and the female cancer patient in the postwar era.

Cancer had often been linked with unhappy emotions in the past, but this association entered a new phase in the middle of the 20th century as a result of research in the field of psychosomatic medicine conducted in the United States during the 1950s. There researchers focused particularly upon cancer in women, and were strongly influenced by the prevailing psychoanalytic orthodoxy surrounding the nature of femininity and normal female sexuality. The results of these studies, which appeared in the Journal Psychosomatic Medicine, confirmed the personality-cancer link out but were rife with erroneous assumptions and faulty methodologies. They were widely publicized, nonetheless, and were instrumental in promoting the association between repression and cancer, especially in women. Despite criticism, their influence was manifest in psycho-oncological research in many countries during the decades which followed and popular notions of the "cancer personality."

[The treatment of "Rybenka": therapies and medical operations on Michal Kazimierz Radziwill, 1702-1762]. / O tym jak "Rybenke" leczono. Kuracje i zabiegi medyczne Michala Kazimierza Radziwilla (1702-1762).

The present paper discusses and analyses treatment methods and medical care given to the Voivod of Vilnius, the Grand Hetman of Lithuania M. K. Radziwill throughout all his life. This analysis is not representative for the general medicine of the 18th century. M. K. Radziwill was one of Poland's richest men of the time and only few aristocrats rich like him could afford similar therapies. The paper is based on unpublished archival sources, such as diaries and correspondence. Radziwill was subject to 65 breedings (blood was taken from his leg) which were usually performed in springtime; 30 leech applications (to his haemorrhoids); and he was cupped 13 times. He ws also treated for his bad jaw, broken arm, and received hydrotherapy (drinking water). All in all, the therapies, operations, and medicines preformed and prescribed to him make up a picture of medicine which, according to today's scientific criteria, did more harm than good to the patient. Nonetheless, this does not change the fact that medical care of the time also included treatments which are well evaluated by present-day medical science, such as, for example, recommending comfort and rest to the patients.

J'ai vu une femme publique'. Sexuality, venereal disease and homoeopathy in nineteenth-century Ghent: the tale of the patient.

Using the casebooks of the Ghent homoeopathic physician Gustave van den Berghe (born Zwevegem, 1836; died Ghent, 1902), this essay reconstructs patients' experience with sexuality and venereal disease during the late 19th century. Van den Berghe's records are uncharacteristic in that they do not translate the patient's descriptions into medical terms. The casebooks therefore represent an opportunity to hear about the disease and its social context in the patient's own words. Reading these case reports carefully, we can begin to understand not only what it meant to suffer from venereal disease, but also what motivated people to seek homoeopathy in general and this healer in particular.

[Hahnemann's use of 'Fragmenta de viribus medicamentorum' in his early medical practice: analysis based on a patient file]. / Die Bedeutung der Fragmenta de viribus medicamentorum in Hahnemanns früher Praxis anhand einer Patientengeschichte aus den Krankenjournalen.

Published in two volumes in 1805, Hahnemann's Latin work Fragmenta de viribus medicamentorum is the first materia medica in the history of homoeopathy. This article examines Hahnemann's use of his own published works in his early medical practice, by focusing on a single patient file from the medical casebooks.