Patients and Words: a Lay Medical Culture?

Abstract

The chronology of medical history is generally organized around medical discourses and the evolution of ‘scientific’ knowledge. The position or role of the patient has long been ignored or, at best, inferred from medical knowledge, past or present. Roy Porter’s call, almost twenty years ago, for the development of a history of medicine from the patients’ perspective has done little to transform this way of considering the medical world of the patient in history.1 Events such as the invention of the clinic and the discovery of the world of the infinitely small, structure the way in which medical history and the history of the patient are written. In fact, a now-famous article written well before Porter’s call, Nicholas Jewson’s ‘Disappearance of the Sick-man from Medical Cosmology (1770–1870)’,2 offers a model explaining the evolution of the patient’s role through history and contributes to shaping the way patient’s history is thought of today. And yet, in the aftermath of Porter’s appeal, much was reported and published on individual or family relations to health in the past. Roy and Dorothy Porter have produced a particularly extensive book based on patients’ lives, strategies and stories.3 Through their research and that of many others, some knowledge about the general reality of patients’ situations, apprehensions and strategies has now been accummulated.4