Catherine L. Thompson. Patient Expectations

That patients are largely missing from many medical histories is an old saw of the medical historical trade. Of course, most medical historians making this observation are pointing out that patients are present passively in medical history, appearing as disease incubators, receivers of treatment, and objects of medical gazes. Catherine L. Thompson’s new work aims to challenge these narrow conventions by “repositioning patients as active shapers rather than passive recipients of their medical care” (3). By analyzing medical therapies, self-medication, changing medical economies, shifting religious beliefs, and standards for malpractice, Thompson shows that nineteenth-century patients helped shape medical therapies. This ability to shape therapeutics, however, was limited to a great extent by other forces transforming nineteenth-century American life. Thompson first substantiates the types of medical therapies common in Massachusetts from the beginning of the Republic through the start of the Civil War. In chapter one, “Medical Practice in Massachusetts,” she uses random samples from the casebooks of five different physicians, whose collective practices covered the period from 1790-1838, to argue that doctors in Massachusetts did not administer heroic therapies anywhere near as often as the writings of Benjamin Rush might lead you to believe. Heroic bleeding and massive doses of calomel were minor players in these five physicians’ therapeutic arsenals. Thompson argues that medical therapeutics in the Early Republic should be “a narrative of continuity rather than the rise and fall of heroic depletive therapy” (32).

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