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This essay explores new models of the citizen-patient by attending to the post-Revolutionary blind 'voice'. Voice, in both a literal and figurative sense, was central to the way in which members of the Hospice des Quinze-Vingts, an institution for the blind and partially sighted, interacted with those in the community. Musical voices had been used by members to collect alms and to project the particular spiritual principle of their institution since its foundation in the thirteenth century. At the time of the Revolution, the Quinze-Vingts voice was understood by some political authorities as an exemplary call of humanity. Yet many others perceived it as deeply threatening. After 1800, productive dialogue between those in political control and Quinze-Vingts blind members broke down. Authorities attempted to silence the voice of members through the control of blind musicians and institutional management. The Quinze-Vingts blind continued to reassert their voices until around 1850, providing a powerful form of resistance to political control. The blind 'voice' ultimately recognised the right of the citizen-patient to dialogue with their political carers.

Drawing on six months of ethnographic fieldwork in the main welfare office of the city of Buenos Aires, this article dissects poor people's lived experiences of waiting. The article examines the welfare office as a site of intense sociability amidst pervasive uncertainty. Poor people's waiting experiences persuade the destitute of the need to be patient, thus conveying the implicit state request to be compliant clients. An analysis of the sociocultural dynamics of waiting helps us understand how (and why) welfare clients become not citizens but patients of the state.

Through analysis of the French experience, this article explores the way economic policy has sought to encourage active, well-informed patients by giving them market power. The new status of the patient as consumer is based on two foundations: the endeavour to build a healthcare market and the activation of demand-based policies. The keystone of this new system is a conception of the market as a process constructed by economic policy. Recent measures such as the standardization of care and the introduction of incentives to respect a treatment pathway then constitute effective levers to establish a free-market rationale.

Whereas traditional social and health histories have viewed the garments of early modern patients accessing hospital care as evidence of their poverty, this article reinterprets the meaning of patient clothing in the context of a venereal disease hospital in Toledo, Spain, in the seventeenth century. Patients carefully selected what they wore as they entered the hospital to produce certain effects on local audiences. Thus, these choices can be understood as body scripts meant to be read in certain ways rather than mere reflections of actual social status. In a context of gendered and social pressures associated with women's sexuality, female syphilitic patients wore garments meant to emphasize respectability and thereby avoid a loss of reputation.

Electronic medical records (EMRs) facilitate fast and accurate access to patient records, which could improve diagnosis and patient monitoring. Using a 12-year county-level panel, we find that a 10 percent increase in births that occur in hospitals with EMRs reduces neonatal mortality by 16 deaths per 100,000 live births. This is driven by a reduction of deaths from conditions requiring careful monitoring. We also find a strong decrease in mortality when we instrument for EMR adoption using variation in state medical privacy laws. Rough cost-effectiveness calculations suggest that EMRs are associated with a cost of $531,000 per baby’s life saved.

We analyze the cost of quality improvement in hospitals, dealing with two challenges. Hospital quality is multidimensional and hard to measure, while unobserved productivity may influence quality supply. We infer the quality of hospitals in Los Angeles from patient choices. We then incorporate ‘revealed quality’ into a cost function, instrumenting with hospital demand. We find that revealed quality differentiates hospitals, but is not strongly correlated with clinical quality. Revealed quality is quite costly, and tends to increase with hospital productivity. Thus, non-clinical aspects of the hospital experience (perhaps including patient amenities) play important roles in hospital demand, competition, and costs.

Until today, it is still unexplored, how modern (scientific) medicine in Western Germany could negotiate its social position in the public sphere and how it was represented in the media. This paper will contribute to the analysis of this problem by investigating all entries on "medicine" in the journal "Der Spiegel" during the period 1947 to 1955, when Western Germany was built up. It is possible to show that the journal was a market place where specific public spheres as e.g. physicians, patients or journalists could discuss medical topics. This way, on the one hand, "Der Spiegel" grasped contemporary notions on medicine and the medical market, which made itself felt in later years of Western Germany. On the other hand, the journal itself molded the discussions about a scientific medicine, which was to be not only innovative but also democratic.

Chagas disease is one of the main endemic illnesses in Latin America. Since 1969 up to the present, the treatment of chronic Chagas patients has been the object of a scientific-medical controversy mobilizing several bodies of knowledge and actors. The resolution of the controversy has direct effects on the health of patients; however, they have been systematically excluded of public debates. In this paper we identified and specified four different steps of the controversy, showing the different positions adopted by the actors implicated, analyzing their statements, the scientific knowledge mobilized during the debates and the consequences for the establishment of norms for the treatment. We conclude showing that what makes up the central issue of the controversy is not what the actors implicated explicitly state as it but the criteria (technical and cognitive) through which are measured and defined "illness" and "cure" states. This research is about a case study in Argentina.

Chronic pain (CP) is a stressful condition that severely impacts individuals' lives. Researchers have begun to explore the role of religion for CP patients, but the literature is scarce, especially for West European populations. Drawing from the transactional theory of stress, this study examined the associations between the religious meaning system and the life satisfaction for a group of CP patients who were members of a Flemish patients' association. To take into account the religious landscape of West European countries, the centrality of one's religious meaning system, rather than religious content, was the focus. Results from the questionnaires completed by 207 patients suggest that the centrality of a meaning system is an important factor in the promotion of life satisfaction for this group, above and beyond the influence of several control variables. Furthermore, the centrality of the religious meaning system moderated or buffered the detrimental influence of pain severity on life satisfaction.

As part of a larger e-health strategy, Canadian governments have invested millions in online health information services for the lay public. These services are intended to reduce demands on the primary health care system by encouraging greater individual responsibility for health and are often promoted using the language of personal empowerment. In this paper, we describe how lay searchers generally look for online health information and discuss the disempowering challenges they are likely to face in (a) locating Canadian government-sponsored health information sites and (b) finding useful information on these sites to address everyday health concerns. We conclude with several recommendations for policy changes.

This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

The São Pedro Hospice was inaugurated on June 29, 1884, and it wa the first psychiatric hospital in Rio Grande do Sul State and one of the first of Brazil, whose history was in a turning point, and it became correlated with the construction of the psychiatry then province. This article presents an abbreviation history of the institution until the decade of 1920, it analyzes the data of the internal population. Moreover, it deals with the medical practices of attendance inside the hospice, which were combined with the development of the "cure" of the subjects, the precepts of the science and the physical and cultural attributes, as well as the experiences of the inpatients' life.

This study investigates the staffing by physicians of the "Hospital Real" in the city of Granada in the 16th century, focusing on the selection processes that preceded their respective and successive appointments. The aim is to illustrate the determination shown by this class of professionals to claim this healthcare space and the academic and socio-cultural requirements that they had to meet in return. These included the possession of a university degree and the accreditation of reputable surgical experience and, to a lesser degree, "limpieza de sangre" (proof of Spanish Christian ancestry) and the title of physician awarded by the local court of the Inquisition.

This article explores the history of the San Juan de Dios Hospital in Cartagena de Indias, at the end of the 18th century. Its activities and evolution cannot be understood unless they are analyzed within the context of the Bourbon sanitary reforms. it was precisely at that time when these reforms were being implemented in Nueva Granada. One of the goals of the reforms was to improve the health of the population in order to discipline the vassals, to promote the growth of the workforce and to increase the Crown's wealth. The text reviews different aspects of the institution, and how it operated. It examines the budget, its expenses, and the dynamics of the hospital population and of its employees. In doing so, it intends to explain what the hospital offered to the city's various social groups.

All researchers agree that individuals can become intoxicated by and dependent on alcohol, tobacco, and other psychoactive drugs. But they have disagreed over whether, and to what extent, drug pathologies comprise a unitary medical problem. Most critically, does addiction have a biological common denominator? Consensus on this question has shifted back and forth. In the late nineteenth and early twentieth centuries, physicians often studied and treated various drug addictions together, working under the "inebriety" paradigm. By the mid-twentieth century the inebriety paradigm had collapsed. Tobacco and alcohol had split off, both in the medical research community and in western popular culture. This article argues that neuroscientific, genetic, epidemiological, and historical evidence helped to reunify the addiction field in the late twentieth century. A new unifying paradigm emerged, variously called chemical dependency, substance abuse, or simply ATOD -- alcohol, tobacco, and other drugs.

Subjectivity and objectivity are central dimensions or perspectives in medicine. During modern times, the "history of the disease" (objectivity) has more and more re-placed the "history of the patient" (subjectivity). But if medicine wants to be human, the physician's and patient's subjectivity and ethics cannot be ignored. During the Middle Ages, the concepts of health and disease are seen from a transcendental point of view, subjectivity was given an objective or spiritual meaning. Processes of secularization, naturalization and individualization deeply influenced medicine in Modern Times. The positivist 19th century laid the foundations of successful scientific medicine; the concept of disease became objective, the length and the quality of life were increased, at the same time, however, medicine witnessed anthropological losses. The 20th century stressed anew the patient's subjectivity and ethics against the scientific objectivity. Integrating psychology and sociology is a similar initiative in this anthropological perspective. The anthropological and ethical permeation of medicine is essential. Disease is not just a physical phenomenon, it is also a psychic, social, and spiritual one. Medical science behaving as human medicine should always and above all see the ill and suffering person.

Cancer had often been linked with unhappy emotions in the past, but this association entered a new phase in the middle of the 20th century as a result of research in the field of psychosomatic medicine conducted in the United States during the 1950s. There researchers focused particularly upon cancer in women, and were strongly influenced by the prevailing psychoanalytic orthodoxy surrounding the nature of femininity and normal female sexuality. The results of these studies, which appeared in the Journal Psychosomatic Medicine, confirmed the personality-cancer link out but were rife with erroneous assumptions and faulty methodologies. They were widely publicized, nonetheless, and were instrumental in promoting the association between repression and cancer, especially in women. Despite criticism, their influence was manifest in psycho-oncological research in many countries during the decades which followed and popular notions of the "cancer personality."

This is the narrative of a patient made before, during and after being incarcerated in an agricultural colony in the Peruvian Amazon. In a vivid style, it narrates the decay of the body, the stigma and the compulsive segregation, as well as the hope for a better life. It is the perspective of a patient, something that is difficult to find when researching the history of health. The original publication was possible thanks to the German physician Maxime H. Kuczynski-Godard and thanks to the Institute of Social Medicine of the University of San Marcos that was directed by the professor of hygiene Carlos Enrique Paz-Soldán. We have used this publication for this transcription. Kuczynski-Godard was a German medical doctor that arrived in Peru in the mid 1930s and organized valuable activities in the Peruvian jungle as a part of an effort, which eventually failed, of the Peruvian State to colonize, or really to "civilize" the Amazon.

S. Filippo Neri (1515-1595), founder of the Congregazione dell'Oratorio in Rome, was a longly debated clinic case for his various pathologies. Eminent scientists, like B. Eustachio and A. Cesalpino, treated him and drew up clinical reports, which were inserted in the Canonization Process and also published as scientific works, and which give useful informations about the history of medicine in the second half of the 16th century. Those reports relate, among others, about many diseases like frequent heart palpitation, shaking tremors heat flame and bronchitic fever episodes, that since hte age of thirty affected the saint. Autopsy revealed cardiac hypertrophia and pulmonary artery dilatation over twice the normal diameter. G. M. Lancisi was the first who formulated the hypothesis of an artery aneurysm, which, according to the present knowledge, can be produced by a post-stenotic dilatation of the pulmonary valve and/or pulmonary hypertension. Tremors and flames can be attributed to hyperthyroidism. Doctors who treated S. Filippo Neri and who shoved to be aware of his psychology, considered his pathology due to supernatural causes. Their conclusions can be understood basing on the medical way of thinking of that age, which was still linked to ancient medicine and limited by the biological and medical knowledge of the time.

The essay II, 37 De la ressemblance des enfants aux pères, written by Montaigne between 1579 and the first months of 1580, is a merciless critique of doctors, doctoring and medicine in general. This Essay, as much as a large number of other texts, of archival records, of iconographic materials produced during the Early Modern period, testifies a wide spread skeptical attitude toward medicine across Europe. This is an important aspect of Early Modern culture. Despite its relevance it has been often neglected by medical historians. This paper aims to show how a literary text can contribute to the understanding of the rise of some aspects of these critical attitudes towards medicine and medics. In Montaigne's text, these attitudes appear to be generated by his personal experiences of suffering and disillusion deeply entangled with a long tradition of philosophical skepticism to which some of his favorite readings belong. Both these elements seem to have also contributed to bring Montaigne in 1580 to the definition of the poetic project of the Essays as a self-portrait: a project in which the bodily presence of the author, with his humors, passions and sufferings, is self-consciously part of the writing process and of the intellectual enterprise.

"Medicine as an art" implies that there is something in medicine beyond the limit of science. The practice of medicine is far more than the simple application of scientific principles to a particular biologic aberration. The communication between a doctor and a patient is the core component of medical practice, but little attention has been generally drawn to it. This study shows three types of doctor's reading on 'patient' as an alternative model to see the doctor-patient communication on the basis of the concept of 'patient as a text' and Bakhtin's narrative theory. They are monologic, dialogic, and discontinuous readings. In monologic reading, the doctor has one - sidedly the whole power in communication and it reflects only the doctor's point of view. The doctor mainly concerns for the disease and its treatment. In the dialogic reading, the power of doctor-patient is shared and their views are reflected each other The doctor should consider the patient as a human and understand his social and psychological surroundings. If the patient refuses to be treated, especially in the case of terminal cancer patient, he has nothing to do with his doctor. Therefore, the discontinuous reading can be applied and in result, no communication takes place between them. To evaluate the proposed types of the doctor's reading on patient, the three types can be applied to the scene of doctor-patient meeting in the novels. The meetings of lieutenant Sung and medical officers in Sending Back by Jung - In Suh are in accordance with the type of monologic reading. In Wan - Seo Park's Three Days in the Fall, the type of dialogic reading can be applied to that of the doctor I's lives with her patients. In Yong - Moon Chun's The Days of Dead Doctors, the type of discontinuous reading can be applied to the events between Haeng - Oh Kim and doctors in ICU. And the 3 parts of whose figure and relationship with Sorok Island have changed throughout the work. The doctors should have abundant experiences of life to make the dialogic reading possible. The dialogic reading can be realized, in its true sense, only if they see the patient not as a disease, but as a man and only if they make efforts to understand his circumstances.

The article examines how tuberculosis patients who were exiled to sanitarium-cities in the state of Sao Paulo reacted to the social representations assigned to them not only by the public at large but by medical workers as well. By evaluating memoirs and related documents from the perspective of the anthropology of disease and the diseased, it was possible to identify the network of signifieds created by the afflicted community.

Samuel Auguste Tissot (1728-1797) was a Swiss physician from Lausanne, who enjoyed a great reputation in his lifetime, thanks to his publications and professional expertise. His personal records contain many pieces of correspondence and more than a thousand written consultations, which are documents describing the disease of a person, that were sent to a physician in order to solicit advice on diagnosis and treatments. This collection is very interesting in many aspects, notably for giving an insight into the patients' points of view. This perspective, which is often difficult to adopt because of the lack of archival materials, has been presented recently as an essential alternative to the traditional history of medicine. Written consultations allow an original reflection on the perception or expression of sickness and shed new light on the patient-practitioner relationship. They reveal a complex network of mediations, that is, actions undertaken by individuals at any step of the epistolary consultations. This article aims at defining the different kinds or levels of mediations that one can find in the documents in order to understand when and why there are sometimes mediators, and which role they play. Such a study should demonstrate that the experience of sickness is not only the business of a single person, but involves several people. The patient-doctor relationship is not exclusively a binary one, but often includes the active participation of third parties.

Patient-history is a recently developed branch of medical-historical search, and its methodology has not yet been sufficiently 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.