On the 16th of January 2013, the first annual lecture in the ‘History of Health and Medicine’ was held at King’s College, London. John Harley Warner (Avalon Professor and Chair, History of Medicine, Yale University) gave an illuminating and fascinating talk on ‘Narrative at the Bedside: The Transformation of the Patient Case Record in the Long Nineteenth Century’ in which he discussed a major shift in the way that patient case records were presented in the latter part of the nineteenth century. Narrative accounts implicating both patient and physician were replaced by stylised case-notes in which standardised visual and graphic representation of information became standard. This shift was contemporaneous with a new conviction in the methods of laboratory science to transform medicine which altered physicians’ perceptions of both themselves and their patients. Warner’s lecture showed the value of analysing historical case records as objects in and of themselves, as well as receptacles of information from which to draw inferences. It stimulated important debate about the way that case records can be linked to changes in hospital practice and the organisation of work.
This lecture came at the end of a series of talks on ‘Cases, Statistics and Government Policies’ which I convened last term. The series aimed to critically address the way in which case records can historically be linked to wider scientific and governmental changes. It began with a talk by Gayle Davis, University of Glasgow, on ‘Public Health, Private Lives: Dr James Craufurd Dunlop and the Collection of Vital Statistics in Scotland, 1904-1930’ which analysed the processes involved in the collection of information on births and deaths in the early 20th Century. Davis explored the methods used in the collection of statistical information from individual cases, raising important questions about the way that vital statistics can be interpreted by historians and demographers. Davis drew attention to the fact that even death was not a clear-cut category in the early 20th-Century. In October, Julia Moses, University of Sheffield, spoke on ‘Producing Accidents, Manufacturing Risk: Workmen’s Compensation and the Origins of the Welfare State in Modern Britain’. Moses’ talk investigated cases of workman’s compensation from the 1870s and explored how these influenced debates on the establishment of welfare policies in Britain, expanding our understanding of how cases within health, medicine and the law factored in the early discussions about an individual’s right to health. In November, we jumped back to the early modern period as Lauren Kassell spoke on ‘Medical Casebooks in Early Modern England’, describing her major project to database and analyse Simon Forman and Richard Napier’s medical case records from the period 1596-1634. Kassell’s work showed how the exploration of cases enables a deep understanding of the way that early-modern medical practitioners perceived and treated the people who visited them, offering a glimpse into these highly-sought-after exchanges.
The series has revealed the value of examining cases records and it has offered interesting and instructive examples of the ways that case records can be linked to broader historical trends concerning the medical marketplace, the collection of information and the use of this information to influence government policies. All speakers alerted us to the importance of studying the way that medical or vital information is collected as this influences the way that it is received and disseminated. As we enter into an age where historical case records can be databased and analysed in new and innovative ways, it is interesting to reflect on the different approaches that historians can offer to understand the complex links between cases, statistics, and government policies.
This new series on the History of Health and Medicine has been supported by the Principal’s New Initiative Fund and continues this term with a series on Religion and Medicine (http://www.kcl.ac.uk/innovation/groups/chh/events/History-of-Health-and-Medicine-seminars.aspx). I look forward to seeing the development of this initiative in rethinking the history of health and medicine. Thanks to all our speakers.