PATIENT HISTORY TAKING

Patient History Taking

Patient History Taking

Introduction

Patient-history is a recently developed branch of medical-historical research, and its methodology has not yet been suf4iciently developed. In particular, the specific character of patient-centered research still has not received sufficient attention. What kinds of questions can, and should, such research attempt to answer, and from which perspectives? This contribution to the discussion offers some help towards the development of ways of orienting such research towards achieving proximity to the patients' viewpoint. This aim is best achieved when the mental picture of patients is reconstructed and, in addition, the specific point of view of the patient is adopted. The article illustrates some possibilities and problems of this branch of research by citing the example of relevant recent German-language studies, especially in the field of the relationship of patients to approved doctors in the nineteenth century.

Discovering the Patient

It has long been known that the subject of patients was strikingly neglected in medical-historical research written in German until a few years ago.' The paucity of resources, to be sure, renders the writing of any history of the patient laborious, and limits the possibilities of research that can be undertaken. But this still does not explain why. Medical-historical researchers, neglecting such sources as do exist, have all too rarely even attempted a history of the patient. This neglect has been due chiefly to a narrow definition of the subject "medicine" often as no more than medical treatment, and also a tendency to deal mainly with academic-medical ideas, discoveries, and inventions and the medical personalities responsible for these. As late as 1986, Weindling in his survey of the research carried out in the social history of medicine in Germany noted the lack of "a history of health seen from below."2 But the patient has, in the meantime, long ceased to be the "terra incognitaH3o f the discipline, even though there are still plenty of gaps to be filled. The patient as subject now plays a significant role in medical-historical research at least when this has a social orientation. This is due to a broader understanding of "medicine" as comprising not merely doctors, but as a historically formed network comprising all concerned.

"Medicine" thus is no longer defined as the sum of scientific findings.

The application of medical science, its diffusion, and society's reception of it lie now at the focal point of such research.

Patient's History towards a Definition

Medical-historical studies subsumed under the topic of "patient's history" deal, in the broadest possible sense, with aspects of the following questions. How did people behave with regard to what in their time was understood as the health, sickness, or healing, either of themselves or of those close to them? How did they perceive these phenomena? What were their attitudes to the various healers? What were their notions of sickness and health? How did they evaluate diagnostic, therapeutic, or preventive offers from others, and how did they use them? Clearly this description neither can nor should define the field of study ...