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249 - Week 8 – Lecture 1 - the Clinical Revolution .docx

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HIST 249
Faith Wallis

Clinical medicine 11/02/2013 The Clinical Revolution New body of knowledge in WM Complex process Multiple factors: intellectual, social, political Institutionalized changes: hospital became medicalized The traditional was an all purpose social welfare place “hospital medicine” new kind of medicine emerged th cultural dimension in the 19 c: by radically changing the way doctors understood disease, they drove a wedge between the doctor sees disease and the patient sees illness disease is what the doctor sees and recognizes illness is what the patient experiences under the old regime (TWM), the doctors disease and the patients wellness were very similar/almost identical they shared a language of whats going on – patients used the same words as the doctors and could understand the images (i.e. the image of imbalance could be understood without being a doctor) the holistic concept of illness extended to the patients lifestyle doctors tended to regard diseases as clusters of symptoms this common vocab was heavily eroding the physicians view of disease became very different from the patients doctors used isoteric language (technical language) – you can only understand it if you have the relevant education and training based on a localistic concept of disease social setting became important bedside vs. hospital (Jewson) old type of medicine = bedside medicine new medicine = hospital medicine cosmology = theory describing the natural order of things (in the sense of anthropology) typology – the idea that there are different kinds of medicine that have existed over time – types rather than stages stages implies progression different types can coexist – bedside medicine still exists even with the mergence of hospital medicine explains the relationship etween the social setting and the knowledge that is being produced the cognitive aspects of medical cosmologies are the result of material processes – political economy of medicine patronage system – patients are social superiors  doctors comes to the patients house shared knowledge, balance, epistemology both patients and doctors are responsible for holding knowledge hospitals before the clinic: france big and numerous run by religious orders or by state hotel dieu – special type of hospital run by religious orders hotel general – run by state housed sick, dependent and deviant of all varieties all purpose institution whole range of socially deviant population “poor” = economically indigent? The French revolution Bold political and social experiment that involved a radical rejection of the past Disenfranchised tha catholic church  all the hstpials across franc ewer withdrawn from the control of the church Revolution was a child of the enlightenment University medical schools disbanded – was a type of guild No more faculties of medicine anywhere in france Dissolved medical corporations, guilds, surgical colleges, academies of medicine Anti-expert ideology Everyone could offer their medical services for a fee – unregulated market  they thought that the revolution would result in a society according to nature, where there was social equality and disease would be abolished disease obviously continued to happen additional factor: 1792 – revolutionary france was at war with all the countries ariund them – soldiers required health services abolished medicine had to be reintroduced 1794 – medical schools were recreated – called Schools of Health “Schools of Health” Antoine Francois Fourcroy Spearheaded three schools of health in france Important new aspects to medical schools: Combined system of education and licensing No more medical guild/colleges to decide on licensing Old division between medicine and surgery was abandon – the enlightenment had always rejected this – fusion of medicine and surgery Read little, see much, do much State was put in charge of the schools Doctors are running the hospitals (won the ppwer truggle with religious authorities) Full-time salaried professors Before, docto
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