The twentieth-century philosopher and historian Michel Foucault has exerted an enormous influence on contemporary philosophy and countless other fields, from ethics and politics to the histories of ideas, of sexuality, and of medicine. As political scientist Brent Pickett notes, ‘a proper encounter with Foucault’s work permanently changes one’s understanding of how people are governed in modern society’ (Pickett, 2005, p. 9).
Together with two colleagues in the Department of History, Chris Millard and James Shaw, I have convened a module this semester that focuses on one of Foucault’s core concepts: biopolitics. Foucault saw biopolitics – that is, how science, technology, and medicine intersect with the powers of the state to control populations – as a defining aspect of the modern age. In other words, the emergence of a biopolitical system in the eighteenth and nineteenth centuries distinguishes our modern world from the premodern societies that came before.
But is there really such a strict division between the modern and premodern worlds? Can’t we find ‘biopolitical features’, such as the taking of a census, in the deep past, too?
Our module explores this question of chronology, (re-)examining both premodern and modern societies alike through the prism of biopolitics. With each week’s seminars considering historical moments, topics, and themes over time, it’s also provided me with an opportunity to reflect on the field of medical history and how our current moment might be viewed in the future.
First, the history of medicine has traditionally taken a long view of medical developments, starting with western medicine’s classical origins (Hippocrates, Galen, etc.) and tracing subsequent advances through the ages. This teleological interpretation of medical history, however, is highly problematic, not least because it presents a carefully curated, western-centred narrative that focuses on famous figures (almost entirely white and male) and their triumphs. In this light, the history of medicine can be followed like an exercise in connect-the-dots, revealing a near constant path of progress.
Thankfully, recent generations of scholars have moved the field far beyond this simplistic storyline. Researchers today, for example, are exploring a wider range of medical practitioners, patients, and types of medical practices while integrating a diversity of sources to try to unlock previously overlooked or unheard voices from the past. Yet the field’s traditional narrative has left a lasting legacy and its effects can be seen in how we often think about medical progress. Put simply, as time goes on, medicine improves as better information, techniques, drugs, etc. replace the old.
But is this always the case? Are all past medical traditions inherently inferior to our current ones?
To be clear, I’m certainly not advocating for a return to an age without antibiotics, germ theory, or vaccines, and I’m incredibly grateful for the achievements of modern medicine. However, I also think there’s a danger in maintaining an unbridled confidence in modern, western medicine that automatically disregards, or even actively disdains, medical traditions from earlier periods and/or different cultures.
An uncritical dismissal of premodern medicine not only seems methodologically suspect and indicative of modern biases, but it also overlooks potentially valuable medical knowledge and practices. Recent work, for example, has demonstrated that medieval medical treatments may be relevant in the fight against antibiotic resistance. Historico- and ethnopharmaceutical studies thus offer exciting opportunities for future drug discovery research – opportunities we cannot afford to ignore.
Moving beyond pharmacy, let’s consider humoral theory, a system of medicine that emerged in antiquity and generally remained popular until it was replaced by germ theory. The idea that health derives from keeping the four humours (blood, yellow bile, black bile, and phlegm) in balance might sound absurd in a modern medical setting. Yet, by rejecting, if not ridiculing, this system without considering it in context, we miss its potentially helpful emphasis on balance and its integration into more holistic approaches to health.
Again, I’m not suggesting we revert back to humoralism or follow the medical advice recorded in medieval manuscripts indiscriminately. I do, however, think that studying this long history is worthwhile, whether it offers potentially practical insights or enables us to re-evaluate our current circumstances from a different perspective.
Indeed, taking a long view of medical history should, I think, provide us with both hope for the future as well as a sense of humility. There is no doubt that medicine has progressed – and at a particularly extraordinary rate in the past two centuries – and I certainly hope that we continue to make progress. There is always room for improvement.
So, what will be said about medicine of the twenty-first century in 2200? Or in 2500? How will our responses to the pandemic be judged by future generations? Or take chemotherapy: if/when cancer treatments become more effective and have less damaging side effects, will chemotherapy be seen as comparable to, say, premodern drugs that are now thought to have hurt patients more than they helped them?
Ultimately, by looking to the past, we can see that we’re not simply travelling down an unwavering path of medical progress – it’s a lot more complicated. Yet, even if the path isn’t straight, the overall trajectory is forward-moving. As we reach new horizons, however, we shouldn’t forget (or be unwilling) to look to the past and survey our new vantage points from multiple perspectives. A deeper understanding of the history of health and medicine can help us to think about our current circumstances and adapt to an ever-changing global healthscape.
Claire Burridge currently holds a Leverhulme Trust Early Career Fellowship in the University of Sheffield’s Department of History. She works on early medieval health and medicine and is particularly interested in exploring the transmission of medical knowledge during the Carolingian period. You can find out more about her research project in Sheffield, ‘Crossroads: The Evolution of Early Medieval Medicine in Global and Local Contexts’, on her project website.
Cover image: A man vaccinating a young child held by its mother, with other members of the household looking on. Oil painting by L.-L. Boilly, 1807(?). Wellcome Collection. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)