I am forwarding the following conference report
Lutz Sauerteig



From:    Hans-Georg Hofer <[log in to unmask]>
Date:    20.02.2004
Subject: Tagber: Health, Medicine and Cultural History
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Centre for the History of Medicine and Disease, Wolfson Research
Institute, University of Durham, Queen's Campus
30.01.2004, Stockton, UK

Report by Hans-Georg Hofer (Institute for the History of Medicine,
University of Freiburg)


Over the past two decades, cultural analysis has influenced the work of
historians of medicine in many ways. Surprisingly, however, debates and
studies on the status of "the cultural" in medicine, and on the
theoretical and methodological offerings of a cultural history for the
history of medicine, have remained in the background of medical history.
This may have to do with the established, strong status of "the social"
in the history of medicine, but also with a certain feeling of
uncertainty vis-à-vis the growing thickets of cultural studies,
resulting in a kind of "wait-and-see" attitude.

"Health, Medicine and Cultural History", a workshop organised by Lutz
Sauerteig from the Centre for the History of Medicine and Disease (CHMD)
at Durham University, took up the relationship between history, medicine
and culture more explicitly. Five speakers and 20 participants from the
UK, the United States, Germany and Austria came together for a
stimulating afternoon to discuss questions such as: What can cultural
history offer to medical history? Which key issues can be identified?
How can a cultural history of medicine contribute to a better
understanding of today's medical discourses and to a critical
understanding of medicine? The event was sponsored by the Wellcome Trust
and the Society for the Social History of Medicine.

Following the welcome address of the CHMD's director, Holger Maehle, an
introduction by Lutz Sauerteig gave an overview of the more recent
readings of the notion of culture. He emphasized the heterogeneous and
encompassing character of cultural analysis, but outlined precisely some
of the key vectors within a cultural history of medicine. These key
vectors - images, material culture, experience and medical knowledge -
turned out to be useful for the workshop's subsequent discussions.

Bertrand Taithe (Manchester) started the line of presentations with a
paper on the cultures of the colonial body in French Empire and
historiography. Critically assessing some of the recent epistemological
approaches to politics in culture (e.g. Foucault and his concept of
governmentality), Taithe discussed the history and historiography of
tropical diseases in terms of a two-way transfer. Diseases not only
represented the import-export trade routes between the "sick" empire and
the nation's health, but were also vicious commodities and signifiers of
colonial domination. For this reason, Taithe argued, it is important to
look at the hybrid character of transfer and interchange in the colonial
spaces. The cultural alienation of French medical practitioners abroad
produced varied discourses of fragility and difficulties of
acclimatising over there and assimilating those from over there.
Consequently, these discourses were crucial for a 'colonial setting', a
mix of knowledge, practices and artefacts, which not only shaped the
construction of colonial bodies but also deeply influenced French
national narratives and their representation in the metropolis.

While Taithe's analysis concentrated on processes of cultural transfer,
Steve Sturdy (Edinburgh) called the workshop's attention to cultural
differences. Sturdy presented a case study by focusing on Edinburgh and
Cambridge as two different cultures of modern medicine. How is
scientific knowledge produced in different local settings, spaces and
practices? How can the methodological views of the science studies, such
as Karin Knorr-Cetina's concept of "epistemic cultures", be used for a
cultural history of medicine? And what, then, is new in cultural history
of medicine? Starting from here, Sturdy's intention was not to raise the
question what culture is, but how culture is done. Between 1880 and 1930
Cambridge and Edinburgh provided two different medical cultures. In
Cambridge, a widely research-orientated medicine, led by physiologists,
tried to develop new experimental methods and tools in laboratories.
These researchers aimed at defining systematic and general forms of
scientific knowledge that were separate from clinical practice. In
contrast, physiology was marginal in the Edinburgh medical school. Much
more prominent were the pathologists, who had a strong interest in
teamwork with clinicians. Therefore, the production of medical knowledge
was more collaborative, involving the whole range of research carried
out by several medical disciplines, and representing a diffuse spectrum
of social relations. By analysing the particular styles of research at
different locations, Sturdy was able to make it clear that a cultural
history of medicine is very much indebted to the sociological studies of
scientific knowledge.

Without doubt, another central issue for a cultural history of medicine
is the realm of material culture. From ancient times onward, a great
many of medical technologies and instruments have been associated with
certain norms, values and signifiers. Julie Anderson (Manchester)
presented a further case study showing how contemporary medical
technology becomes part of our lives. In her paper, entitled "The
Cultural Significance of the Artificial Hip", Anderson looked at hip
replacement surgery and its representation in popular magazines. During
the 1970s, this technology has become a routine surgical practice in
western societies and is now often taken for granted as an invisible
metal-plastic implant. The hip replacement surgery raised a broad
spectrum of responses in the mass media. What makes the story of the
artificial hip so successful? Here again, one of the workshop's main
issues, the acting and doing of cultures, was of utmost interest. The
question is not what an artificial hip is, but what it does: it keeps
elderly people in motion, making them mobile and socially flexible. It
is only the capability of moving that makes an "active life" possible,
thus changing the notion of what old age is and when it starts. This
metal-plastic object tells stories about how women and men can
experience and reinvent their ageing bodies as active ones.

The relationship between patients' experience and medical discourses has
recently gained much attention in body history. How did early modern
women and men experience and construct their bodies? How did traditional
and new medical knowledge influence them? Michael Stolberg (Würzburg)
has studied these questions by looking into a vast number of patients'
letters and autobiographies. Taking nervous disorders as an example,
Stolberg pleads for a microhistoric, patient-orientated approach within
a cultural history of medicine. New medical theories might have captured
the scientific discourses rapidly but hardly affected the way people
explored their bodies. In fact, letters written by patients reflected
multi-faceted and individual narratives of bodily experience, mixing a
broad range of popular and medical depositories of knowledge. For this
reason, there is much evidence to suggest that the acceptance of a new
medical paradigm very much depends on how people perceive and construct
themselves in times of social change, looking for sense-making,
trust-inspiring explanations. It was also here that the workshop
encountered the problem of the material presence of the body.
Discussions circled around some open questions of body history, such as:
if only language can constitute the very possibilities of experiencing
and conceptualising the body, what about its material existence, what
about the flesh, the nerves and the bones? How do ideas and knowledge
become flesh? Do we really have to limit ourselves to saying that there
remains a gap between discourse and experience?

Mark Jenner (York) closed the circuit of the speakers by picking up
again the problem of the multiple notions of "culture" and the "boundary
drawing" that each methodological turn claims for itself. What is, for
example, the status of public health in a cultural history of medicine?
Based on his research into 16th- and 17th-century English conceptions of
cleanliness and dirt, Jenner approached the invention of modern
sanitation from an anthropological perspective. A culturally inspired
history of public health has to involve the "cultures of dirt",
analysing the cultural construction of pollution, environmental
problems, medical policies, urban civic orders, norms of behaviour, and
social reforms in terms of overlapping discourses. Clearly, this
approach should not lead into an arbitrary understanding of culture,
producing a huge, shapeless rubbish heap of symbols, signifiers,
figures, and images. In other words, it will not do to understand
culture as a cacophony of discourse effects. Only different models of
culture, Jenner emphasized in view of his example, are able to
deconstruct the linear, teleological story of public health in
modernity.

In this sense, Jenner's paper was the connecting piece to a summing-up
of the workshop's results. I became clear that cultural history
challenges the history of medicine in many ways. The workshop
demonstrated how historians of medicine have grappled with the issues
raised by cultural analysis and gave strong evidence of the deep
entanglement of medicine with culture(s). What next? What are
heuristically useful approaches to a cultural history of medicine?
Speakers and participants agreed that there is neither a single notion
of culture nor a key concept which historians can synthesize by looking
into the past. Moreover, to claim a cultural "turn" in the history of
medicine seems inappropriate. Doing cultural history is not to suspend
the more recent approaches and results of social history, simply
substituting "the social" by "the cultural". Instead, cultural history
continues, amplifies and intertwines what historical, sociological and
anthropological studies of medicine have offered. Culture is context and
contingent, culture is eclectic and heterogeneous, and culture always
demands emphasis on encompassing perspectives. Precisely because of
this, however, a cultural approach in the history of medicine should be
careful to generalisations of its approaches and results. The term and
notion of culture differ strikingly depending on what one is looking at.
By looking at the self-construction and self-experience of bodies, the
production of medical and scientific knowledge and its socio-political
consequences, and by looking at the significances of medico-technical
artefacts, we see different notions and understandings of culture. For
this reason, a cultural history of medicine is probably at its best when
it is done in case studies - keeping the rich offerings of cultural
analysis in view, but referring to a specific approach and understanding
of culture.

URL zur Zitation dieses Beitrages
<http://hsozkult.geschichte.hu-berlin.de/tagungsberichte/id=394>