Abstract
People who write about early medicine take a great deal of trouble to avoid addressing the question of efficacy. Some trustfully accept physicians’ claims—Western or Eastern, ancient or modern. Others dismiss reports of cures except for the few instances, mostly of drugs, in which biomedicine has validated the therapy. Physicians generally agree with the skeptics, shrugging off the rich literature of medical case records as mere anecdotes, by which they mean that none of it is worth thinking about. The utility of religious or other popular curing does not come up.
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Notes
- 1.
This essay is part of a book in progress about the spectrum of health care in ancient China. I have been working on various avatars of it since the early 1970s, when I had the pleasure of working with Charles Gillispie on coverage of China for the Dictionary of Scientific Biography. I offer this in thanks for all I have learned from his scholarship.
- 2.
“Placebo effect” is a woefully confused term, which some users restrict to the use of inert placebo as a drug and most use for the sum of verified effects that medicine cannot explain. See H. Spiro (1997, pp. 40–41).
- 3.
Morris represents the third stance. For examples of the first and second in the same volume see, respectively, Shapiro & Shapiro and Price & Fields.
- 4.
The classic study is R. A. Rubinstein & R. T. Brown (1984). Lock & Scheper-Hughes (1996, p. 67), discuss ADHD as an instance of recasting social frictions and miseries as “individual pathologies rather than as socially significant signs.” On current National Institutes of Health doctrine re ADHD, see Medline Plus at http://www.nlm.nih.gov/medlineplus/attentiondeficithyperactivitydisorder.html (accessed 2011.10.11). For other examples of important discrepancies in diagnosis and therapy in the U.S. and Western European countries see Payer (1988). This meritorious book is out of date, but no one has done a comparable survey since.
- 5.
See, for instance, Price & Fields (1997), which even takes the last dichotomy seriously (pp. 133–134).
- 6.
Aronowitz (1998), p. 51, in a historical analysis of ulcerative colitis. On p. 52 Aronowitz lists several reasons for the demise of psychosomatic medicine.
- 7.
For significant national differences in diagnosing causes of death in the late twentieth century see Payer (1988, p. 25).
- 8.
For xulao, see Zhu bing yuan hou lun, juan 3, p. 17a–juan 4, p. 27b; xulao re, juan 3, p. 19b; xulao hanre, juan 3, p. 22b; xulao guzheng, juan 4, pp. 23a–23b; xulao fanmen, juan 4, p. 23b; xulao ouni tuoxue and xulao ouxue, juan 4, p. 24a; possession disorders, juan 24, pp. 130a–134b.
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Sivin, N. (2011). The Question of Efficacy in the History of Medicine. In: Buchwald, J. (eds) A Master of Science History. Archimedes, vol 30. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2627-7_19
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