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Put Out Your Tongue! The Role of Clinical Insight in the Study of the History of Medicine

Published online by Cambridge University Press:  17 May 2012

Martin Edwards
Martin Edwards
Affiliation:
Martin Edwards, Honorary Research Associate, The Wellcome Trust Centre for the History of Medicine at UCL, and General Practitioner, The Jenner Practice, 201 Stanstead Road, London SE23 1HU, UK. Email: martin.edwards@ucl.ac.uk
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Historians of medicine are often gloomily familiar with clinicians' incursions into their intellectual arena. We physicians offer hagiographic biographies of obscure nineteenth-century medical figures, triumphalist narratives of medical progress and – the most heinous offence – retrospective diagnosis of ailments afflicting historical characters. But clinicians have also offered some excellent insights to the discipline. As a medical practitioner, I intend to argue that clinical insight can be valuable; not in providing answers – here, clinicians' contemporary interpretations of disease and its treatment can lead us to become unstuck – but in raising questions which might not occur to historians.

Keywords

Tongue InspectionTongue DiagnosisNineteenth-Century Clinical ExaminationNineteenth-Century DiagnosticsClinical Experience
Type
Articles
Information
Medical History , Volume 55 , Issue 3 , July 2011 , pp. 301 - 306
Copyright
Copyright © The Author(s) 2011. Published by Cambridge University Press

References

1 For the outcome of this line of enquiry see Martin Edwards, Control and the Therapeutic Trial: Rhetoric and Experimentation in Britain, 1918–48 (Amsterdam: Rodopi, 2007).

2 Thomas Watson, Lectures on the Principles and Practice of Physic (London: Longmans, Green & Co., 1871), 145–6.

3 Andrew Whyte Barclay, A Manual of Medical Diagnosis: An Analysis of the Symptoms and Signs of Disease (London: John Churchill, 1857), 33.

4 W.F. Clarke, A Treatise on the Diseases of the Tongue (London: Renshaw, 1873), 34.

5 T. Newham, ‘On the Tongue as a Means of Diagnosis’, The Lancet, 63, 1608 (1854), 661–2.

6 Anon., ‘Pilferings’, Pick-Me-Up Magazine, 4, 27 October 1888.

7 A few examples to illustrate this point are included within this text.

8 This statement is based upon my ongoing analysis of published eighteenth and nineteenth-century case reports, and examination of archived case notes from St Bartholomew’s Hospital.

9 J.S. Haller Jr., ‘The Foul Tongue: A 19th Century Index of Disease’, Western Journal of Medicine, 137 (1982), 258–64.

10 Clarke, op. cit. (note 4), preface.

11 W. Howslip Dickinson, The Tongue as an Indication in Disease (London: Longmans, Green & Co., 1888), 1–2.

12 Ibid., 4.

13 Nancy Holroyde-Downing, ‘Mapping the Tongue: Travel and Transformation’, presentation from ‘The Future of Medical History’ conference, The Wellcome Trust Centre for the History of Medicine at UCL, London, July 2010.

14 John Abernethy, Surgical Observations on the Constitutional Origin and Treatment of Local Diseases; And on Aneurysms (London: Longman, Hurst, Rees & Orme, 1809), 22.

15 For one of many contemporary accounts of Abernethy’s consulting style see Anon., ‘John Abernethy’ [Pen and Ink Sketches of Poets, Preachers and Politicians, 1846], St. Bartholomew’s Hospital Journal, XLI, 5 (1934), 87–90.

16 Abernethy, op. cit. (note 14).

17 Editorial, ‘The Tongue in Diagnosis’, The Lancet, 244, 6316 (1944), 381.

18 T.H. Howell, ‘Constipation and Furred Tongue’, The Lancet, 279, 7244 (1962), 1413–4.

19 Benjamin Ridge, Glossology: Or the Additional Means of Diagnosis of Disease to be derived from Indications and Appearances of the Tongue, 2nd edn (London: Reynell & Weight, 1857), 5–6 (his italics).

20 Lionel S. Beale, On Slight Ailments: Their Nature and Treatment (London: Churchill, 1882), 26.