Doctoral Dissertation Improvement Grant: Sociocultural Factors Affecting Medical Constructs of the Consumptive in Nineteenth-Century Scotland

在简·E博士的监督下。Buikstra，人类学研究生Amy W. Farnbach将研究如何理解和治疗疾病是由社会和文化因素塑造的。她将在苏格兰进行研究，这是现代西方医学思想发展的关键环境。Farnbach女士将使用19世纪的档案记录来调查结核病（TB）的医学理解，当时被称为消费，以及结核病患者的可变治疗。这项研究将包括世纪在格拉斯哥、爱丁堡、邓迪及其周边地区运营的29家医疗机构的患者病历和其他文件。利用这丰富的语料库，研究人员将解决两个主要的研究问题。 首先，患者的社会类别和不断变化的结核病医学知识如何影响医生对结核病的看法？ 第二，19世纪苏格兰的医生用什么指标来诊断消费，这些指标的一致性如何？为了解决第一个问题，她将分析患者记录和医务人员之间的记录讨论，以确定医生是否将男性和女性的结核病归因于不同的原因，或者以不同的方式对待工人阶级和更高地位的结核病患者。 对于第二个问题，研究人员将对患者记录中被诊断为结核病、消耗病和其他疾病的病例记录的临床指标进行卡方分析，以测试“消耗”是否有严格的临床定义或更宽松的诊断。 在世纪，结核病影响了惊人数量的生命。 即使在今天，尽管自世纪中期以来已有抗生素治疗，但这种疾病在世界范围内仍然很常见，这在很大程度上是因为许多患有这种疾病的人未经治疗。 虽然众所周知，医生对结核病患者的态度可能会影响患者是否寻求和遵守药物治疗，但人们对这一点的作用机制知之甚少。本研究将有助于社会科学对影响医疗实践的非科学因素的理解。 它也将有助于澄清当代西方医学对结核病和结核病患者的假设，通过检查他们的历史根源。

Under the supervision of Dr. Jane E. Buikstra, anthropology graduate student Amy W. Farnbach will investigate how the understanding and treatment of disease is shaped by social and cultural factors. She will conduct her research in Scotland, a critical setting for the development of modern western medical ideas. Ms. Farnbach will use nineteenth-century archival records to investigate medical understanding of tuberculosis (TB), then known as consumption, and the variable treatment of TB patients. The study will include patient medical records and other documents from twenty-nine medical institutions operating during the nineteenth century in Glasgow, Edinburgh, Dundee, and their surrounding areas. Using this rich corpus of materials, the researcher will address two major research questions. First, how did patient social categories and changing medical knowledge of TB affect doctors' ideas about the disease? Second, what indicators did doctors use to diagnose consumption in nineteenth-century Scotland, and how consistent were those indicators? To address the first question, she will analyze patient records and recorded discussions among medical personnel to determine whether doctors attributed men's and women's TB to different causes, or approached working-class and higher-status TB patients differently. For the second question, the researcher will undertake chi-square analysis of the clinical indicators recorded in cases diagnosed as TB, consumption, and other diseases in patient records, to test whether "consumption" had a strict clinical definition or was more loosely diagnosed. During the nineteenth century, TB affected a staggering number of lives. Even today and despite antibiotic treatments available since the mid-twentieth century, the disease remains common worldwide in large part because many with the disease go untreated. While it is known doctors' attitudes toward TB patients are likely to affect whether patients seek and comply with medical treatment, how this works is poorly understood. This research will contribute to social science understanding of the non-scientific factors that affect medical practice. It also will help to clarify contemporary western medical assumptions about TB and TB patients by examining their historical roots.