Exploring Illness
Time and Place

c u l t u r e s


s y m p t o m s

Fevers and Chills

An Injured Limb

Swollen Sores

About this Site

This web site is designed to explore how the experience, diagnosis, and treatment of illness has changed over time. By exploring sets of symptoms, this site seeks to show some of the multitudinous ways illness has been understood by humans. There is no right way to explore this site. Follow the links that appear most interesting to you. Skip around as you see fit. Although the site is designed around many of the questions and issues explored below, it aims to help you ask your own questions and come up with your own answers.

Several questions are explored through this site: How has medical practice changed over time? How is medicine related to culture? How have names for illness changed over time? How does viewing our own medical practices from a historical perspective change how we understand our current, familiar practices? In exploring these issues, this site raises more questions than it answers. It is our hope that you will leave the site with a broader appreciation of the relationship of medicine to culture, and an understanding that our own medical practices look different when seen in a historical context.

In exploring this site, we ask you to grapple with a fundamental, radical idea. This idea is that illness, the feeling and experience of being sick, is itself a historical object. The first idea is that illness and medicine are not static phenomena. Different people in different time periods can experience, understand, and treat similar groups of symptoms very differently. A swelling on the skin may be understood as a reflection of bodily imbalance, a reaction to the entry of harmful environmental elements, or a cancerous tumor. Cycles of fevers and chills may be identified as being a particular disease, part of a general pattern of seasonal health, or an internal struggle of opposing yet complementary forces. These are more than just descriptions; they influence the actual experience of having illness, and strongly influence the treatment. A body that is out of balance feels pain in a manner that is subjectively different than a body fighting a battle against an external attacker. Relief caused by the releasing of harmful fluids is different than the relief of realigning a body's equilibrium through acupuncture. We believe that illness changes over time. Thus, to fully understand illness we need not just biological explanations, but also historical explanations. We need both medicine and the history of medicine.

Related to this radical idea is a second. This is the notion that illness, and the medical responses to illness, are intimately related to cultural worldviews. How we see the world structures how we experience and shape the world we live in. What make particular responses seem reasonable emerge from specific and contingent cultural values. The judgments about what medical practices are effective and sensible are value judgments made in the context of broader cultural beliefs about how the world works, our place in that world, and what is morally good and bad. This web site attempts to summarize the medical worldviews of four temporally located cultures to help you make sense of their medical practices. Our aim is to help you understand why blood-letting, for instance, was a rational and sensible healing activity in the early 19th century.

One of the great values of this approach is that it can help us better understand our own medical practice as intimately related to our cultural worldview and better understand the unstated assumptions that guide it. Using the anthropological notion of strangeness, we present a jarring, unexpected view of late 20th century American medicine. The pages on 20th century American medicine using thick description to highlight unusual details that reflect the deeply held, but usually unstated, norms of our society. By uncovering these norms, we invite you to question them. This is of more than academic interest. Billions of dollars are spent every day in our health care system, and many people's most intimate moments of birth and death occur in hospitals. By understanding that medical practice has changed over time and is directly connected to cultural values gives us power to examine it in a new light. Nothing about our current practices is inevitable, and as citizens, we should feel empowered to demand that medicine be responsive to current human needs.

Finally, it is easy to read the history of medicine as one of constant progression leading from barbaric roots to a sophisticated and universally correct scientific approach as embodied in current medical practice. This web site suggests that both these notions are problematic. First, medicine in other time periods and cultures was not wrong because it lacked knowledge that we have today. Based on cultural values and contemporary knowledge, other cultures developed advanced treatments that were effective and sensible for their people. The practice of bleeding, often seen as a barbaric practice, is a logical and effective treatment when illness is understood as a disequilibrium of the body's fluids. Conversely, in a century or two our own medical practices may seem backward and nonsensical. Wrenching treatments like chemotherapy and unequal distributions of health care resources may be seen by our great-great-grandchildren as equally savage and cruel. We cannot know what the future looks like, but the past suggests that only change is inevitable. Thus, you are encouraged to view the medical cultures examined on this site equally, and not with the idea that former practices have led simplistically to our own superior knowledge.

This site is comprised of a series of symptom descriptions explored from the perspectives of four cultures: Greek medicine at the time of Hippocrates (5th century B.C.E.), Chinese medicine at the time of the Han dynasty (2nd century B.C.E. to 2nd century C.E.), American medicine at the beginning of the 19th century, and American medicine at the close of the 20th century. To introduce you to the medical worldview of each of these cultures, we have included an overview essay that examines several aspects of the culture's medical practice. We ask: how did they perceive bodies? Where did illness come from? How should it be treated? Who was involved in the medical community? Did illness have moral connotations? Secondly, three sets of symptom categories are examined from each culture's perspective. For each group of symptoms, we ask: how were these symptoms understood? What was the recommended treatment? Who performed the treatment and where? What was the likely outcome? Both the cultural overviews and descriptions of the treatment procedures are intended to be mutually reinforcing. By understanding the culture you can understand the treatment procedure and vice versa.

As a final note, we hope to expand this site to provide a richer and fuller exploration of these questions. To come up with a more sophisticated understanding of changes in medicine over time, more cultures and more types of symptoms will need to be explored. Promising areas for further research include medicine in India, Africa, and Latin America, as well as a greater number of time periods. Despite the limitations of the current approach, we will be satisfied if you leave asking more questions than when you entered.

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