Guenter B. Risse

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Guenter B. Risse (born 28 April 1932) is an American historian of science and medicine. The American Association for the History of Medicine awarded him the 1988 William H. Welch Medal for his book Hospital Life in Enlightenment Scotland and its Lifetime Achievement Award in 2005. He is Professor Emeritus, Department of Anthropology, History and Social Medicine, at the University of California, San Francisco, and currently Affiliate Professor of Bioethics and Humanities at the University of Washington in Seattle.

Biography

Of German parents, Risse is a native of Buenos Aires, Argentina where he obtained his baccalaureate degree from the Colegio Nacional in 1951 prior to gaining admission to the University of Buenos Aires School of Medicine. Following graduation with a magna cum laude M.D. in 1958, he came to the US to complete an internship and training in internal medicine.[1] In 1962, Risse returned to the classroom, following admission to the University of Chicago. Originally enrolled at the Oriental Institute, he studied ancient Egyptian culture and language under the direction of the distinguished Egyptologist John Wilson. A 1965 plan to participate in an excavation project in Saqqara near the suspected tomb of Imhotep, the ancient god of healing, was not approved by the Egypt Exploration Fund because the dig was restricted to trained archeologists.[2] Such an outcome and shifts in excavation plans following UNESCO's call to save Nubian monuments from the impending flooding caused by the new Aswan Dam, induced him to transfer to the History Department. Here he worked under Professors Allen G. Debus and Lester S. King, obtaining his Ph.D. in 1971. His dissertation dealt with eighteenth-century medical systems, notably the theories of the Scottish physician John Brown and their impact in Germany during the early 1800s.[3]

Risse held academic appointments at the University of Chicago (1963–67), University of Minnesota (1969–71), University of Wisconsin-Madison (1972–1985), and University of California, San Francisco and Berkeley, (1985–2001).[4] As chair, he developed and organized the Department of the History of Medicine in Wisconsin during the early 1970s, as well as the Department of the History of Health Sciences in San Francisco in the late 1980s. He is a member of the American Association for the History of Medicine, History of Science Society, European Association for the History of Health and Medicine, also holding corresponding memberships in several European and Latin American societies; he was also elected to the now defunct International Academy of Medicine in 1977. A fellowship from the World Health Organization in 1979 allowed him to study the history of Latin America's heath care systems. As part of this project, he established close relationships with the Sociedad Mexicana de Historia y Filosofia in the early 1980s.[5] In addition, Risse was a fellow at the Institute for Advanced Studies at the University of Edinburgh in 1986 and the Sir Logan Campbell Distinguished Visitor at the University of Auckland School of Medicine in 1994. He was active in the creation of the European Association for the History of Health and Medicine and co-sponsored the establishment of the International Network for the History of Hospitals. He is also a past president of the American Association for the History of Medicine (1988–90).

Scholarship

Reflecting his early interest in ancient Egyptian medicine, Risse published an analysis of the heretic Pharaoh Akhenaten's purported illness and a new translation and interpretation of case 7 in the Edwin Smith Papyrus in 1972.[6] At the urging of his history professors at the University of Chicago, Risse shifted his research to health and medicine in eighteenth-century Scotland with the main focus directed towards events and personalities in its former capital, Edinburgh, then an international Mecca for medical studies, including the noted American physician, Benjamin Rush. Two grants from the American Philosophical Society allowed him to travel to Scotland and explore the archives. Several articles and two books illustrate the role played by the teachers and students of Edinburgh Medical School in shaping Western medical education and research. Following on themes developed in the doctoral dissertation, some featured its most prominent professors and students. Among the latter was John Brown, creator of an unorthodox medical system that became the inspiration for German philosophers during the romantic period.[7] Risse's effort to ground the leading ideas of Naturphilosophie in Brownian constructs received wide attention and lead to the publication of other works on this subject.[8] Brown's teacher, William Cullen, considered the leading contemporary British clinician, also became a focus of study. Like several prominent medical men of its time, Cullen conducted a large portion of his medical practice through the mails. Assembled in 21 volumes from 1755–90, a study of his correspondence with patients and their doctors offers a fascinating glimpse of patient-physician relationships and contemporary therapeutics.[9]

Using a multitude of surviving documents, including hospital registers, ward ledgers, lecture notes, patient records and medical publications, the award-winning Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh (Cambridge 1985) employed nearly a thousand individual clinical histories, sampled and subjected to computer analysis.[10] A valuable appendix prepared by the pharmacologist-historian J. Worth Estes examined the actual usage of drugs by one of the attending physicians, Andrew Duncan, Sr. This first complete account of institutional life in an eighteenth-century British hospital revealed not only the spectrum of diseases selected for medical intervention, but also the outcomes of treatment. The book demonstrated that through careful patient selection and basic institutional support, the Infirmary was far from being a "gateway to death," playing instead a benevolent and educational role that placed it among the top European hospitals of its time. As one reviewer observed, this argument challenges the generalization that the eighteenth-century hospital was a death trap. "Risse's contribution must be considered a palpable blow to prevailing thought concerning hospital historiography."[11] The employment of patient records consolidated the notion that this material was a valuable source for studying the history of medicine.[12]

A more recent publication, New Medical Challenges During the Scottish Enlightenment (Rodopi, 2005) explores a wider range of social and medical practices, exposing the contradictions and ambiguities found in eighteenth-century Scottish health, science and medicine. Separate chapters examine a number of key issues, including the role of charity, medical debates and competition, vivisection, and contemporary diseases such as 'pulmonary consumption', 'mill reek' and 'ague'.[13] Special chapters are devoted to 'female troubles', 'hysteria' and 'hypochondriasis', showing the evolving relationships across gender and class lines between poor patients and their physicians. To place medical ideas and practices into proper context, the essays offer extensive background information and rediscover the lost voices of prominent physicians involved in promoting health and battling illness.[14] The book is both a 'medical history from below' and an analysis attentive to civic and institutional context, geographic factors, and the complex connections between medical matters and the social practices such as diet, health, bodily comportment, and (albeit differently for men and women) moderation and modesty. Reviewers considered the book an important contribution to the social history of Scottish Enlightenment medicine, tracing debates within medical institutions, reproducing the notes of anxious bedside physicians, following diagnostic disputes, and "understanding how matters of livelihood and rank, then as now, limited access to health care."[15]

Of wider scope are Risse's publications on the history of disease and hospitals. His interests in the former began with an essay on ancient Egyptian paleopathology, followed by an examination of the influence of disease on medical thought and practice in ancient Greece.[16] More recently, he wrote an introductory article to the Cambridge World History of Human Disease, (Cambridge, 1993) and an essay on epidemics before AIDS.[17] His subsequent involvement with this new disease in San Francisco generated a spate of articles and his co-sponsorship in 1988 of an AIDS History Group at the American Association for the History of Medicine meeting in New Orleans.[18] The highly fatal epidemic prompted a series of comparisons between the previous appearances of bubonic plague in San Francisco: the San Francisco plague of 1900–1904. Although dissimilar in many respects, an investigation of both outbreaks helped advance the understanding of issues such as stigma, denial, resistance, and race. Risse's plan for a monograph based on such resemblances was originally formulated in the early 1990s but never completed. His current writing project focuses on the creation of the first Chinese hospital in America. Another recent project proposes to seek alliances with historical ecologists, medical geologists, as well as evolutionary and molecular biologists to advance our knowledge of disease from antiquity to the present by taking advantage of a growing body of scientific discoveries from ancient bacterial to human DNA.[19] To illustrate this approach, Risse organized a session in May 2007 at the American Association for the History of Medicine meeting in Montreal titled "History in the Post-Genomic Era: New Perspectives on Health, Disease and Medicine," illustrating examples of such insights for understanding Neolithic hunters, the medieval Black Death, and 20th century pandemic influenza.[20]

In the field of hospital history, Risse not only published essays about Scotland and New Spain, but contributed articles about the evolution of the modern hospital in several reference works, including the Encyclopedia of Bioethics (1995), Encyclopedia of the Enlightenment (2003), Europe 1450 to 1789: Encyclopedia of the Early Modern World (2003), and Oxford Encyclopedia of the Modern World: 1750 to the Present (2008). His major book Mending Bodies—Saving Souls: A History of Hospitals (1999) narrates the transformation of hospitals from houses of mercy to tools of confinement, from dwellings of rehabilitation to spaces for clinical teaching and research, from rooms for birthing and dying to institutions of science and technology. From their beginnings, hospitals were places of spiritual and physical recovery. The story, unfolding from ancient Greece to the era of AIDS, is told in a dozen episodes featuring a series of emblematic institutions and the fate of particular patients while covering key diseases and developments in the history of medicine and therapeutics. Reviews have marveled at the book's historiographic ambition at a time when "master narratives" and "long histories" are no longer in fashion. Yet, Mending Bodies, Saving Souls furnishes a unique insight into the world of meanings and emotions associated with hospital life, including stories of patients and caregivers. By conceiving of hospitals as houses of order capable of taming the chaos associated with suffering, illness, and death, readers can better understand the significance of their ritualized routines and rules. "Risse's book has already achieved the status of a standard, and it surely will reach the status of a classic which it well deserves," wrote one reviewer.[21]

Finally, Risse's work as a medical educator is reflected in a series of articles in which he sought to promote the importance of historical perspectives in the training of new physicians. Borrowing from the world of medical gadgetry, he introduced students in the use of the "retrospectoscope," only selectively employed in obtaining medical histories, to a wider context that included comparative past and present models of environment, health and healing. Based on his experiences at the University of Wisconsin Medical School, he advocated for a new "utilitarian" approach that deliberately linked contemporary medical issues with pertinent past developments to foster reflection in assessing the nature and impact of change. The medical present could only be fully understood in light of the past.[22]

Before his academic retirement, Risse addressed the future of history in medical education, arguing for a two-pronged approach: employ the past for an inward and outward look at medicine. The former sought to expose students to the stories of past healers and patients from different historical periods and social contexts, to be integrated with the current ward and clinic experiences of these students. The goal was to allow them to step back from the present with the aid of historical examples, reflecting on the cultural, political and economic contexts of medicine. More importantly, Risse suggested that such explorations in history could lessen the isolation and anxieties of medical students as they realized the timelessness of human relationships surrounding sickness and death while undergoing a difficult process of professionalization. The outward look was equally important; physicians do not practice in a vacuum, and history is capable of pointing out the social structures, economics, and functions of the medical system. This is particularly true in an era of diminished professional autonomy and alternative healing practices, rise of corporate health insurance companies and pharmaceutical companies. Risse's final provocative hypothesis blamed, in part, the amnesia of American medical leaders for the profession's current plight, depriving practitioners of their past, forgetting that history provides identity and solidarity, perspective and understanding. In the new millennium, medical history is as relevant as ever in the face of rapid changes.[23]

Bibliography

Books and monographs

Editor and contributor, Modern China and Traditional Chinese Medicine, Springfield: C. Thomas, 1973. Editor and translator, History of Physiology, by K. E. Rothschuh, Huntington: R. E. Krieger, 1973 and 1981. Edited with R. L. Numbers, and J. W. Leavitt, Medicine Without Doctors: Home Health Care in American History, New York: Science History Publications, 1977. Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh. New York: Cambridge University Press, 1986. Edited with Victoria A. Harden, AIDS and the Historian: Proceedings of a Conference at the National Institutes of Health 20–21 March 1989, Bethesda: N.I.H. Publications, 1991. Edited with Robert Jütte and John Woodward, Culture, Knowledge and Healing: Historical Perspectives of Homeopathic Medicine in Europe and North America, Sheffield: European Ass. for the History of Medicine and Health Publ., 1998. Mending Bodies—Saving Souls: A History of Hospitals, New York: Oxford University Press, 1999. New Medical Challenges During the Scottish Enlightenment, Amsterdam: Rodopi, 2005. (Clio Medica 78) "Plague, Fear and Politics in San Francisco's Chinatown", Baltimore: Johns Hopkins University Press, 2012.

Selected articles and book chapters

"Medical Certainty and Kant's Critical Philosophy," in The Influence of Early Enlightenment Thought upon German Classical Science and Letters, New York: N. Watson, Science-History Publications, 1972, pp. 27–36. "Calomel and the Rise of American Medical Sects during the Nineteenth Century," Mayo Clinic Proceedings 48 (1973): 57–64. "The Renaissance of Bloodletting: A Chapter in Modern Therapeutics," Journal of the History of Medicine 34 (1979): 3–22. "Once on Top, Now on Tap: American Physicians View Their Relationships with Patients, 1920–1970," In Responsibility in Health Care, ed. G. J. Agich. Dordrecht, Holland: Reidel Publishing Co., 1982. pp. 23–49. "Medicine in New Spain." In Medicine in the New World: New Spain, New France, and New England, ed. R. L. Numbers, Knoxville: Univ. of Tennessee Press, 1987, pp. 12–63. "Hospital History: New Sources and Methods," In Problems and Methods in the History of Medicine, ed. A. Wear and R. Porter, London: Croom Helm, 1987, pp. 175–203. "The History of Therapeutics," In Essays in the History of Therapeutics, ed. W. J. Bynum and V. Nutton, Clio Medica 22 (1991): 3–11. "Medicine in the Age of Enlightenment," In History of Medicine in Society, Historical Essays, ed. A. Wear, Cambridge: Cambridge Univ. Press, 1992, pp. 149–95. "A Long Pull, a Strong Pull, and All Together: San Francisco and Bubonic Plague, 1907–1908," Bulletin of the History of Medicine 66 (1992): 260–86. "Revolt Against Quarantine: Community Responses to the 1916 Polio Epidemic, Oyster Bay, New York," Transactions & Studies of the College of Physicians of Philadelphia 14 (February 1992): 23–50. "The Politics of Fear: Bubonic Plague in San Francisco, California, 1900," in New Countries and Old Medicine, ed. L. Bryder and D. Dow, Auckland, NZ: Pyramid Press, 1995, pp. 1–19. "Before the Clinic was "Born": Methodological Perspectives in Hospital History," in Institutions of Confinement: Hospitals, Asylums and Prisons in Western Europe and North America, 1500-1950, ed. N. Finzsch and R. Jütte, New York: Cambridge Univ. Press, 1996, pp. 75-96. "Cause of Death as a Historical Problem," Continuity & Change 12 (1997): 1-15. "The Road to Twentieth-Century Therapeutics: Shifting Perspectives and Approaches," in The Inside Story of Medicines-A Symposium, ed. by G. J. Higby and E. C. Stroud, Madison, Wis.: Amer. Inst. Hist. Pharmacy, 1997, pp. 51–73. "Shelter and Care for Natives and Colonists: Hospitals in Sixteenth-Century New Spain," in Searching for the Secrets of Nature: The Life and Works of Dr. Francisco Hernandez, ed. by S. Varey, R. Chabran and D. B. Weiner, Stanford: Stanford Univ. Press, 2001, pp. 65–81. "Reflected Experience in Medicine, Science and Technology: The Example of Hospital History," in Historizität: Erfahrung und Handeln-Geschichte und Medizin, ed. A. Labisch and N. Paul, Stuttgart: Steiner Verlag, 2004, pp. 253–63. "Translating Western Modernity: The First Chinese Hospital in America," Bulletin of the History of Medicine 85 (2012): 413-447.

Sources

  1. ↑ Dr. Risse's poignant recollections of his early medical education and experiences in various hospitals in Buenos Aires and then in the United States are recounted in his preface to Guenter Risse, Mending Bodies—Saving Souls: A History of Hospitals (New York: Oxford University Press, 1999), pp. xiii-xviii.
  2. ↑ Walter Emery, Professor of Egyptology at University College London, conducted the excavations during the 1960s, publishing only a handful of preliminary reports before his death in 1971. To this day, Imhotep's tomb has not been found.
  3. ↑ "The History of John Brown's Medical System in Germany during the Years 1790-1806," Ph.D. dissertation, Department of History, University of Chicago, 1971.
  4. ↑ Dr. Risse's basic academic biographical facts, from his M.D. in Argentina in 1958 to his appointment to the University of California, San Francisco in 1985, are published in Guenter B. Risse, "Medico-Historical News and Activities," Bulletin of the History of Medicine, 59(1985): 247-49.
  5. ↑ Guenter Risse, "The AAHM and Medical History in Latin America: An Update," Bulletin of the History of Medicine 55(1981): 113-5. Dr. Risse reported on this in "Medical History in Latin America," Clio Medica 15(1981): 233-45.
  6. ↑ "Pharaoh Akhenaton of Ancient Egypt: Controversies Among Egyptologists and Physicians Regarding his Postulated Illness," Journal of the History of Medicine 26 (1971): 3-17, and "Rational Egyptian Surgery: A Cranial Injury Discussed in the Edwin Smith Papyrus," Bull. New York Acad. of Medicine 48 (1972): 145-58.
  7. ↑ "John Brown," in Klassiker der Medizin, ed. D.v. Engelhardt and F. Hartmann, 2 vols., Munich: C. H. Beck, vol 2, pp. 149-95; "The Brownian System of Medicine: Its Theoretical and Practical Implications," Clio Medica 5 (1970): 45-51.
  8. ↑ "Philosophical Medicine in Nineteenth-Century Germany: An Episode in the Relations Between Philosophy and Medicine," Journal of Philosophy and Medicine 1 (1976): 72-92, and "Schelling, Naturphilosophie and John Brown's System of Medicine," Bulletin of the History of Medicine 50 (1976): 321-34.
  9. ↑ "Doctor William Cullen, Physician, Edinburgh: A Consultation Practice in the Eighteenth Century," Bulletin of the History of Medicine 48 (1974): 338-51, and "Cullen as Clinician: Organization and Strategies of an Eighteenth-Century Medical Practice," in William Cullen and the Eighteenth-Century Medical World, ed. A. Droig et al, Edinburgh: Edinburgh University Press, 1993.
  10. ↑ Guenter Risse, Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh (New York: Cambridge University Press, 1986).
  11. ↑ J. T. H. Connor, Canadian Bulletin of Medical History 5 (1988): 78-79.
  12. ↑ (with John Harley Warner) "Reconstructing Clinical Activities: Patient Records in Medical History," Social History of Medicine 5 (1992): 1-23.
  13. ↑ "Ague in Eighteenth-Century Scotland? The Shifting Ecology of a Disease," and "Mill Reek in Scotland: Construction and Management of Lead Poisoning," in New Medical Challenges, pp. 171-228.
  14. ↑ "In the Name of Hygieia and Hippocrates: A Quest for the Preservation of Health and Virtue," New Medical Challenges, pp. 135-69.
  15. ↑ Charles W.J. Withers, Bulletin of the History of Medicine 81 (2007): 867-68.
  16. ↑ "Paleopathologia en el Antiguo Egipto," in Republica Arabe Unida, Asuntos Cientificos, Buenos Aires: United Arab Republic Scientific Publications, 1964. Vol. 2, pp. 47-64, and "Epidemic and Medicine: The Influence of Disease on Medical Thought and Practice," Bulletin of the History of Medicine 53 (1979): 505-10.
  17. ↑ "Epidemic and History: Ecological Perspectives and Social Responses," in AIDS: The Burdens of History, ed. E. Fee and D. Fox, Berkeley: University of California Press, 1988, pp. 33-66.
  18. ↑ "Epidemics Before AIDS: A Research Program," in AIDS and the Historian, ed. V. A. Harden and G. B. Risse, Bethesda: National Institutes of Health, 1991, pp. 2-12.
  19. ↑ See, for example, Richard Pollack, Signs of Life: The Language and Meanings of DNA, 1994.
  20. ↑ "American Association for the History of Medicine 80th Annual Meeting Program May 3–6, 2007 Montreal, Quebec, Canada," (AAHM, distributed to meeting attendees), p. 7.
  21. ↑ Alfons Labisch, J. Hist Med. 56 (April 2001): 180-82.
  22. ↑ "The Role of History in the Education of the "Humanist" Physician: A Re-Evaluation," Journal of Medical Education 59 (1975): 458-65, and "Teaching Medical History in the 1970s: New Challenges and Approaches," Clio Medica 10 (1975): 132-42.
  23. ↑ "Teaching History: Medicine's Expanding Universe," Proceedings 37th International Congress of the History of Medicine, ed. C. Burns et al., Galveston: Univ. of Texas Medical Branch, 2002, pp, 223-7.

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