ESHS/HSS Annual Meeting

How Rarity Begins: The Sociable Construction of Novelty in Modern Medicine

• In Event: Rarity in Medicine 1: New Narratives

English Abstract

Rarity must begin with novelty. The new then remains unusual or becomes frequent. This paper opens up exploration of how and why nosological novelty happens in modern medicine, through a fresh historical observation. Founders of clinical medicine in Paris put no new diseases on the books. Their London and Dublin counterparts made their names this way. Why? Examples point to commonalities (London and Dublin) and contrasts (Paris) in how cases were documented, shared, and generalized in the nineteenth century. These patterns, in turn, seem rooted in forms of sociability and communication. Medical societies, training systems, journals, doctor-patient relations differed surprisingly, on a spectrum from the personal to the formal or bureaucratic. These comprised a varied economy of values and virtues – epistemic, social, practical – in what mattered as a contribution to the medical art and science. The variety reflected differences in scale, power relations, and social structure in and around the new, hospital-based medicine. In these ways, addressing a specific historical problem and contrast allows re-examining aspects of the birth of the clinic: hospital medicine as a uniform type, the workings of cases and evidence, implications of pathological anatomy, quantification and alternatives to it, and what happened to what patients felt and said in medical knowing.

Author

• Andrew Mendelsohn, Queen Mary University of London