Towards a ‘Medicalised’ History of Medicine?

As a late follow-up to my last post about a potential future for the history of medicine, I want to dedicate this article to the issues that arise when using medical categories and sources for historical investigations. Especially the previously mentioned terms of ‘trauma’ or ‘collective memory’ are highly disputed and remain blurry in their definitions – not least because they lack a definite character within medicine as well. Due to this deficit and the modernity of the terms, critics claim that the use of ‘trauma’ in history and commemoration practices, for example, would be similar to the utilisation of Darwinism to explain social and political phenomena in the 19th and 20th century. Therefore, in this post, I want to discuss the pitfalls as well as the potential use of medical terminology and understanding of the history of medicine’s future.

In the past, history always tried to defend its place in society with the problematic attempts to ‘scientificate’ the discipline – not least, also due to the introduction of economic principles in the humanities. The use of statistics and network analysis, for example, is quite common now, especially for social and economic historians, to validate their claims and base their analysis on something more ‘objective’ than reports or statements. Indeed, this sources’ objectivity crumbles quickly on second sight: statistics often show a lack of definitions, clear distinctions and are often revised multiple times. In this process, an exact overall number of cholera cases, for example, becomes unobtainable. Subsequently, a proportional analysis can be complicated and result in a distorted picture of the development. What is the value of (medical) statistics for history if they cannot be trusted?

Simple answer: history is always subjective. It always pursues a purpose and tries to understand the (selfish) actions and the human behaviour of the past – not limited to politics, warfare, diplomacy, everyday life and, indeed, medicine. The biggest issue of history is that we cannot escape our limitations: we argue and analyse with the knowledge, the concepts, the ‘ideology’ and the mentality we have today. Moreover, studying remembering practices, we quickly realise that we do not stand above the ephemerality of memory and the bias, inherent in recollecting events or information, which is essentially the primary task of historians. The awareness of this predisposition in our writing, however, is the most valuable tool, which history has to offer. Many other disciplines, including medicine, have become mainly ‘scientific’, claiming that there can only be one answer, one truth (one diagnosis, one treatment strategy, and so on).

Therefore, the use of medical categories and statistics is inevitable for historical investigation. For example, ‘trauma’ as a concept did not exist in the post-Second World War era. Despite the absence, however, people did suffer from trauma-related disorders – they only had neither the medical knowledge yet nor a platform to address their psychological conditions. In the civilian context in post-war East Germany, general categories like ‘irritable weakness’ or ‘nervousness’ were present, which had social rather than medical implications regarding stigmatisation and alienation. Treatment, however, was not documented, apart from severe cases of schizophrenia and depression. It becomes apparent that there was an awareness of the psychological suffering of town inhabitants (experience of air raids, street fights, loss, disease, starvation, rape, etc.) outside of the military context – nonetheless, broader diagnoses such as ‘Shell-Shock’ and the corresponding treatment remained limited to soldiers.

In this respect, today’s concept of ‘trauma’ can provide some insights into the connection between a traumatic event, the traumatised individual or group, and the subsequent medical conditions or social behaviour. Nevertheless, this can only be a starting point for historical analysis and requires the broader social context: retrospective diagnoses are untenable. Moreover, recent accounts in Germany, for example, over-use ‘trauma’ in many ways – it became a term for politics, remembrance, history, and individual biographies. This development is exactly the issue, which Svenja Goltermann and Michael Heinlein pointed out, where ‘trauma’ is utilised as a ‘generalised’ excuse and explanation for personal narratives, political actions, and social phenomena. A pitfall with wide-ranging implications for presenting the past and legitimising the current societal conditions and the social contract (for example, homogenising victimhood under the umbrella of ‘trauma’, etc.).

However, I would claim that in this regard, history as a discipline can be useful and expose the inherent bias of these developments. Subsequently, a history without acknowledging the medical categories and concepts of today as well as their limitations for historical investigations and public practices would lose sight of its relevance as the link between the past and the present – and as the consciousness of society to (idealistically) prevent history from repeating itself. The history of medicine cannot stand above the medical knowledge from today. However, it can provide the medical profession and society with the understanding of moralised and socially defined diagnoses, derived from the past, as well as defend ethical standards for medical research and practice in the future.

Selected Bibliography:
Archival Sources from Town Archiv in Dresden and Leipzig as well as from the Bundesarchiv-SAPMO in Berlin
Assmann, Aleida, Der lange Schatten der Vergangenheit: Erinnerungskultur und Geschichtspolitik (München: C.H. Beck, 2006)
Goltermann, Svenja, ‘The Imagination of Disaster: Death and Survival in Postwar West Germany’, in Between Mass Death and Individual Loss: The Place of the Dead in Twentieth-Century Germany, ed. by Alon Confino, Paul Betts, and Dirk Schumann (New York: Berghahn Books, 2008), pp. 261–74
Heinlein, Michael, Die Erfindung der Erinnerung. Deutsche Kriegskindheiten im Gedächtnis der Gegenwart (Bielefeld: Transcript, 2010)
Hunt, Nigel C., Memory, War and Trauma (Cambridge: Cambridge University Press, 2010)
Levine, Peter A., Trauma and Memory: Brain and Body in a Search for the Living Past. A Practical Guide for Understanding and Working with Traumatic Memory (Berkeley: North Atlantic Books, 2015)
Radebold, Hartmut, ‘“Kriegskinder” im Alter: Bei Diagnose historisch denken’, Deutsches Ärzteblatt, 101 (2004), A1960–62

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