There’s always something new in the past.

The historical record differs depending on who looks back and what questions they ask. All scholars limit their gaze; those who concentrate on medical history are interested in how healers have cared for the wounded and sick at various times. These medical historians talk about the practices of healers from the past, in part just to "know" and also to inspire contemporary doctors to be humane and compassionate; their writings, teachings, and research can influence and shape politics. This article is based on an exhibit about medical historians that is on display at the National Library of Medicine (1).

In the nineteenth century, warring groups of medical practitioners vied with each other to attract patients, promoted different types of therapies, and glorified their own practices. They often ridiculed the practices of the others, pointing out their shortcomings.

"Hydropaths" advocated "Water Cures" and "Rain Baths." Their philosophy was that water was crucial for purifying and invigorating the body. "Thomsonians," named for their founder Samuel Thomson, emphasized the natural capacity of the body to heal itself. They recommended that patients use herbal or "vegetable" medicines extracted from common plants. "Homeopaths" believed that "like cures like." They gave their patients tiny amounts of drugs that produced the same symptoms that the illness itself produced. "Allopaths" treated patients with remedies that counteracted the symptoms for which they were prescribed, much as doctors do today.

By the turn of the century, the allopaths had largely triumphed in the war among the camps. They used advanced scientific methods, which gave them credibility that the other groups lacked. And they had a strong organization, the American Medical Association, which they founded in 1847.

But some doctors worried that, with this new emphasis on science, the humanistic side of medicine would be lost. Sir William Osler, for example, a doctor and professor at Johns Hopkins University, tried to meld the new scientific approach with the older concern for humanity. Osler was known for his "careful observation of the sick person, who saw him as a friend even while being the subject of a most intense scrutiny (2)."

Another doctor who brought the lessons of history into his practice and teachings was Henry Sigerist. Sigerist was a doctor and historian at Johns Hopkins University from 1932 to 1947. He gave speeches all over North America, emphasizing that "we study the history of science...because we need a broad scientist who is not a mere technician but is prepared to take an active part in the general life of the community....Science alone is useless as long as it is not integrated into the pattern of our social and economic life (3)."

Sigerist questioned the traditional organization of private medical practice and offered proposals for "socialized medicine" that would make medical care equal and available for everybody. He was dynamic and influential and even appeared in 1939 on the cover of Time magazine -- an honor no other medical historian has received so far.

Sigerist’s position on the importance of medical history to medicine was that "medical history teaches us where we come from, where we stand in medicine at the present time, and in what direction we are marching. It is the compass that guides us into the future (4)."

Medical historian Theodore Brown says that, since the 1960s, many historians of medicine have been "resurrecting the spirit of Sigerist." They have been trying to make history "relevant to the people and to pressing contemporary social issues and problems."

For example, in 1981, historian James Jones published the book Bad Blood. It documented how, from 1932 to 1972, doctors in the U.S. Public Health Service conducted unethical experiments on African-American men in Tuskegee, Alabama who had syphilis. Throughout the 1980s and 1990s, newspaper and magazine articles and television documentaries popularized the story that Jones recounted in Bad Blood. Dr. Vanessa Gamble, a physician and historian at the University of Wisconsin Medical School, led a campaign during this time to pressure the government to apologize to the men who had been in the Tuskegee syphilis study and their families. Finally, on May 16, 1997, President Clinton apologized on behalf of the U.S. government.

Two other books by medical historians -- Deadly Dust and Dying for Work -- prompted the federal government to pass laws in the 1990s to protect workers from job-related hazards. The books by David Rosner and Gerald Markowitz directed public attention to problems that confront sand blasters. Sand blast workers breathe dust from sand particles that are emitted in the blasting process. They can develop silicosis, a disabling and sometimes fatal lung disease, and they were not routinely warned of their risk. As a result of these books, the sand blast industry is now required by law to warn workers fully about health hazards they may encounter at the workplace.

Early in the twentieth century, a medical historian wrote that "if a distinct place were assigned to medical history in the medical curriculum it could...form one of the most useful and inspiring features in the whole scheme of medical education (5)." Now, late in the century, many medical schools have added historical study to their curriculums, acknowledging that history has much to contribute to the contemporary medical scene.

1. The exhibit, "So, what’s new in the past?: The Multiple Meanings of Medical History," is on display at the National Library of Medicine on the campus of the National Institutes of Health in Bethesda, Maryland through September 30, 1997.
2. Osler Aphorisms, R.B. Bean and W.B. Bean (Abelard-Schuman Ltd., NY: 1950).
3. These comments are from a radio talk given by Sigerist on November 10, 1946.
4. See Arch Pathol Lab Med, January 1997, 121: 84-90.
5. Arnold C. Klebs, "The History of Medicine as a Subject of Teaching and Research," Bulletin of the Johns Hopkins Hospital, January, 1914.