The hit-and-miss history of medicine

Tuesday 01 April 2003 00:00 BST
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The Open University's fascinating new course on the history of medicine should have universal appeal because, says co-chair Dr Deborah Brunton, "everyone's been sick".

"We've all at some time come away from our doctor thinking he or she was a wonderful professional or an absolute quack," she adds. "It doesn't matter how far you go back, nothing changes. Everyone can identify with this."

Students will explore a wide range of topics within medicine in Europe from 1500 to 1930, examining the experience of patients, popular understandings of health and disease and the rise of the medical profession and the state's role in providing health care.

"We show how medicine is shaped by the social and economic context of the day," says Dr Brunton. "Despite the course title no knowledge of history or medicine is required. We simply show how the discipline has been revised through the ages."

While the course does take in some of medical history's more illogical theories and their downright dangerous practitioners – until as late as the mid-19th century it was possible to become a doctor simply by putting up a sign – it focuses as much on developments shaped by social influences, including living conditions, religious beliefs, war and even art and literature.

"The early 1500s, for example, saw the Renaissance, the rise of humanism and the new explorations of anatomy," explains Dr Brunton. "Through the ages, perception of illness changed and people who died were no longer seen as struck down by God or providence, but nature."

The study also shows how practical knowledge increased through necessity to treat new ailments borne of changing social conditions. Doctors learnt about syphilis because infected soldiers took it back to their home communities. The benefits of the industrial revolution were countered by a rise in infectious diseases that thrived in squalid working conditions. And as medicinal advances saw people live longer, the doctors had a new challenge – tackling degenerative diseases of old age.

The course is split into two chronological parts, with a natural break at 1800, a time of major advance in medical thinking. "After the French Revolution, people stopped thinking about diseases as an imbalance of fluids and started investigating specifically diseased organs," says Dr Brunton. "This was partly inspired by successes in surgery and led eventually to research into cell pathology.

"They worked out that if an organ was diseased they could cure by removing it. Of course, along the way they learnt such an approach was not always successful – removing a person's diseased thyroid gland for example caused other problems."

The course's broad range of material also takes in the impact of inventions, the obligations of gentry to contribute practically to the health care of their poor neighbours, the rise of medical schools and a change in the popular image of doctors from fat, lazy buffoons to frock-coated, respected pillars of society. This second-level study uses videos and a CD-Rom packed with over 300 fascinating – if occasionally horrific – pictorial images of practical medicine.

"A lot of this course is about human nature," says Dr Brunton. "That always has endless fascination. We explore, for instance, the rise in the number of women doctors, who were only taken on at London medical schools after 1914 when men were away at war. But when the men returned from war they took all the women's places – partly because all the hospitals played each other at rugby and wanted students who were good at it. This course tells people about people."

For more information about A218 Medicine and Society in Europe, 1500-1930, visit www.open.ac.uk/courses or ring 01908 653231, quoting ALDOE

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