Thinking with Disease (and Tuberculosis): Disease as Malfunction of the Parts from the Premodern World to Modern Pathology

Part of the Reynolds-Finley Lecture Series, hosted by UAB Libraries Historical Collections

Modern conceptions of disease often depend on concepts of causal mechanisms, loss of function, anatomical lesions, or, especially recently, statistical deviations and risk factors. Everyone seems to know that medieval medicine (Latin and Arabic) and early modern European medicine was something else, and centered on a general imbalance of bodily “humors” such as blood, phlegm, yellow bile, and black bile. This talk demonstrates the deep roots of anatomical thinking with disease in ancient sources, which often seated diseases in the parts. The Roman anatomist and physician Galen developed an influential pathology centered on conditions of the body that impaired the function of its parts. This model persisted into the early modern period, and mutually reinforced the spread of pathological dissections in the 1500s and 1600s in Europe. By the 1600s, many medical schools in European universities elevated revealing the states and causes of diseases in post-mortem dissections to the pinnacle of pathological knowledge. They joined this study of diseased parts to regular clinical teaching in hospitals, alongside chemistry and medicinal botany. By 1800, the long traditions and practices of anatomical-clinical medicine served as the foundation of thinking with disease in Parisian modern hospital medicine. Tracing the long history of humanity’s battle to understand and treat tuberculosis will be a primary thread across the centuries and civilizations.

Evan Ragland, Ph.D., associate professor of history at the University of Notre Dame, is a historian of science and medicine who specializes in the histories of academic medicine, scholarship, pedagogy, and experimentation in early modern Europe. He is also building a long history of concepts of disease, building on his earlier work that demonstrated the importance of functional-anatomical concepts to pre-modern and especially Galenic medical traditions. He teaches undergraduate and graduate courses in the histories of science and medicine, science and religion, and science and ethics.

Ragland’s first book, "Making Physicians: Tradition, Teaching, and Trials at Leiden University, 1575-1639" (Brill, 2022) detailed the training of physicians in late Renaissance Europe through university pedagogy in texts, debates, making medicines, a range of anatomical practices, and bedside teaching in private settings and the hospital. Through medical education, thousands of students learned to emphasize personal experience, the observation and communication of facts, intellectual and manual skill, and even the performance of tests and experiments. Their medical book learning encouraged students and professors to develop a new, anatomically localized theory of consumption around the development of pulmonary tubercles, lesions revealed in their frequent post-mortem dissections.

Ragland is currently revising a book manuscript titled "Experimental Medicine," describing how medical training and practice in the related disciplines of anatomy, chymistry, and clinical practice became experimentalist in the seventeenth century.

Future projects aim to assemble and analyze a long history of concepts of disease, from Mesopotamian medicine into the nineteenth century (Thinking with Disease), and to recover the ethical visions and goals of the new sciences in the early modern period (Remaking the World).

Ragland’s articles have appeared in journals such as "Isis," the "journal of the History of Science Society," "The Bulletin of the History of Medicine," "Early Science and Medicine," "Ambix," and the "Journal of Early Modern Studies," and he has published chapters in several edited volumes. His work has won the Shryock Medal from the American Association for the History of Medicine and the Partington Prize from the Society for the History of Alchemy and Chemistry.

His work has received support in major grants and fellowships from the American Council of Learned Societies, the National Science Foundation, The Edelstein Foundation, The Chemical Heritage Foundation (now the Science History Institute), and The Scaliger Instituut of Leiden University.