Get Divide and Conquer: A Comparative History of Medical PDF

Science Medicine

By George Weisz

This wide-ranging publication is the 1st to envision some of the most major and attribute beneficial properties of contemporary drugs - specialization - in old and comparative context. in response to study in 3 languages, it lines the origins of recent scientific specialization to 1830s Paris and examines its unfold to Germany, Britain, and the USA, exhibiting the way it advanced from an outgrowth of educational instructing and study within the nineteenth century into the dominant mode of clinical perform by means of the center of the twentieth. Taking account of the parallels and modifications in nationwide advancements, the publication exhibits the foreign hyperlinks one of the international locations' clinical platforms in addition to the self sufficient affects of neighborhood political and social stipulations within the stream towards specialization. An epilogue takes the tale as much as the twenty-first century, the place difficulties of specialization merge into the bigger predicament of wellbeing and fitness care which impacts such a lot western countries this day.

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Extra info for Divide and Conquer: A Comparative History of Medical Specialization

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The ordinances establishing the Paris Faculty of Medicine in 1803 and the Academy of Medicine in 1820 specified that these institutions should The Rise of Specialties in Early Nineteenth-Century Paris 15 be devoted to the advancement of medical knowledge. 65 In these state institutions, models of disciplinary specialization were first elaborated. But administrative logic also operated on another plane, making possible the flourishing of research in a network of specialized hospitals. Unlike the private, semi-entrepreneurial institutions of London, these were part of an extensive municipal system that was set up after the French Revolution.

40 One form that such visibility for specialists took in Paris was a slowly growing trade in private teaching of specialties. Among forty-four private courses listed in Hubert’s Almanach of 1830,41 there are only ten specialty courses, seven of them devoted to obstetrics; of the three others, Pierre-Paul Broc taught a course in andrology; Octave Lesuer, in legal medicine and toxicology; and P. S. Ségalas in diseases of the genito-urinary organs. Twenty years later, however, Meding’s directory listed eighty-nine private courses being offered.

The crux of my argument here is that emerging specialization in Paris was based on the coming together of a system of career competition based on some notion of advancing medical knowledge—which itself promoted specialization—with classificatory categories that emerged from efforts to impose bureaucratic rationality on huge institutional structures. Both these elements were promoted directly, though in quite different ways, by the French state. Fifth, there was no sharp distinction between medical research and practice because, except for a handful of laboratory scientists or specialists in public health, research was based in clinical practice, most often though not exclusively in hospitals.

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