How to Read Between the Lines in Historical Medical Texts

The Step-By-Step Guide to Reading Historical Medical Records

Thanks to digital libraries and archives, we have access to tons of historical texts that date back to the BC era. But is all this information essential in our analyses? Not quite. As you may very well know, medicine is prone to bias. Here is how you can avoid replicating the same in your research:

Step 1: Understand the Context

Researchers may do their best to remain objective, but the truth is that they are subject to external influences. Say, for example, that you are sure that adding turmeric to food will help people lose weight. Your data collection and analysis might lean on proving this hypothesis to the point that you may ignore evidence to the contrary. Such biases happen in the world of medicine. So, rather than simply reading the words penned down by an author, take the time to understand who they were and the context of their research. How so?

• Who were they, and who did they write it for? Figure out who the author was and their position in society or the institution they worked for. For context, a healer's perspective may have been worlds apart from that of an academic, as the two would have had different experiences and would have catered to different audiences.
• Where did they publish their work? Back in the day, medical reports were published across different platforms, from government reports to local pamphlets and school books. The format of a book gives you context as to how many people it reached and how trusted it was based on an authority scale.
• What was happening in society? Medicine always ties to social events. For example, in times of epidemics, the literature focused on prevention and treatment approaches. And in times of war, the focus was on treating physical wounds, and the best ways to facilitate faster healing in the wounded. The medical ideas you come across will reflect what was happening in society, and taking note of this is important.
• How original is the book you are reading? With archives and libraries digitizing their records, more historical texts are available to researchers and the general public. However, it is important to note that the versions you see online may not always be the original manuscripts. They could easily be later printed versions or modern transcriptions of the original text. And such changes pave the way for edits and errors, which can affect the accuracy of the book.

Having understood the author's world, you will have a much easier time drawing parallels between their medical perspective and the modern-day medical problems that could benefit from it.

Step 2: Decipher the Language

Not only have medical strategies changed over the years, but also their terms. So, how can you ensure that you grasp what authors have written? You will need to create your own historical glossary that covers the following:

• Disease names. It might seem quite funny or strange, but there was a time when healers confidently referred to some diseases as consumption or dropsy. That second one, in particular, referred to congestive heart failure! Seeing as we no longer use such terms to refer to diseases, you might have a hard time figuring out that ague relates to malaria and that consumption is what we have come to know as tuberculosis. And in many cases, some of the diseases you will come across will not have a specific counterpart in the modern world. So, what's the way forward? First, you will need to use historical disease dictionaries to find the modern names of the diseases you find. And if you cannot find them, you will need to use their descriptions to match modern-day ailments. Keep in mind that if you are matching symptoms, there is room for ambiguity.
• Medical terminologies. If you go back to the Galenic and Hippocratic ages, physicians referred to the body in terms of humors. And there were terms like black bile and phlegm. But what really are these? These ages are not the only ones with specific terms that we no longer use in the medical world. And to figure out what texts mean when they refer to things like sanguine temperament, you will need a medical history dictionary.
• Pharmacology. Over the centuries, researchers have adapted drug formulations to not only make them more effective but also safer for patients. So, you are likely to come across some older compounds whose active components have been banned, renamed, or are unknown. Given the specificity of such formulations, the only way forward will be through researching historic formulations.

Old English dictionaries can help you with some of the words. But to avoid mistakes, it is best to find a medical history dictionary set in the time period of the books you are reading.

Step 3: Evaluating the Biases

As we said earlier, the medical industry is subject to biases because, as we all know, there have been prejudices over the centuries. And these show in the medical literature. Here are some of the things to consider when reading medical books set in previous eras:

• The class bias. For a long time, most of the published work in the medical field was written by the educated elite. You may note this when contextualizing the books you come across, such that those that rank high in terms of authority will tie to the educated in society. And they often wrote these books with the aim of setting themselves apart as the valid practitioners while casting a shadow on folk healers, midwives, and other people offering their medical services. So, some of the narratives you come across will have a touch of this bias.
• The gender bias. Believe it or not, there was a time when women's bodies and health conditions were trivialized as the medical field, which was quite patriarchal, saw women as fragile. At some point, physicians even came up with terms like hysteria to describe women's health issues, citing that it was all in their heads. While we have made strides in uncovering just how complex women's bodies are, and more physicians have advanced studies in this regard, be aware of this bias.
• The social bias. Beyond elitism, we also have to talk about the dark past in medical history. Take the slavery era as an example. At the time, it was quite acceptable for physicians to publish medical reports that justified racism. They even came up with diseases to explain the need to use forced labor. But race was not the only factor in social biases. People from lower socioeconomic backgrounds were also affected. When they fell ill, their diseases were often tied to their moral failings, such as laziness and alcohol, rather than the structural failings that predisposed them to these illnesses.

As such, when reading historical medical texts, there is a need for introspection. As you read each perspective and the narrative it shapes, ask yourself whose voice is missing because, truth be told, patients seldom had the chance to record their stories. This marginalization was especially worse for poor patients as well as those who were subject to racism.

Step 4: Drawing the Parallels

Despite some of the shortcomings in historical medical texts, we cannot deny that this body of research has played a pivotal role in medicine as it is today. After all, if ancient physicians had not started treating the body as four humors, how would their successors have gone on to conduct autopsies and study the body at the cellular level? There is a lot of value in this knowledge, and here is how you can use it for good.

• Medicine. If you are in the medical field, you can use historical medical knowledge in two ways. The first one is to understand diseases better. Diseases go through several phases, including their discovery down to when the medical industry finds a way to treat, cure, or manage them. Take syphilis as an example. The concepts surrounding this disease changed quite a lot from the 15th to the 20th century. We even got to a point where people realized that this disease could remain dormant in the human body, only to cause mental disorders when patients were in their golden years. By tracking disease appearances and descriptions over the years, you can learn much more about their evolution. But that's not all. The second way to use this information is to explore patterns in drugs. Many of the drugs we use today have been tested for a long time and have gone through several therapeutic cycles. The same goes for drugs used in previous centuries. If you can map these patterns in the innovation of remedies, you can find some similarities that you can use to simplify the drug research process or make it safer.
• Social sciences and humanities. The sociological aspects of medicine are ripe with research angles. Not only can you dig into studies on the stigma associated with illnesses, but you can also use historical information to cover the social determinants of health for people in the past or the relationships that existed between patients and their doctors. With all the biases that were in play in previous eras, digging into these sensitive yet informative areas of research can provide valuable information to both patients and physicians. You can also replicate the same in the modern day. And if you want to venture beyond medical sociology, how about ethics? You have likely heard of some troubling medical procedures that were considered quite normal back in the day, such as lobotomies. Or you may have heard about how people shunned those with mental illnesses. Past medical research is awash with many cases of questionable medical practices, which can provide you with material to provide context as to the appropriateness of past practices. What's more, you can use these practices to set the stage for modern bioethics and to determine how effective they are.

And there is another angle that you can take, regardless of your field - how knowledge was created, validated, and shared in the previous eras. A good look into how researchers developed experimental methods would help you understand more about previous methods and assess their validity in the context of modern-day research standards.