När kroppen slöt sig och blev fast : Varför åderlåtning, miasmateori och klimatmedicin övergavs vid 1800-talets mitt

Sammanfattning: For 2500 years, bloodletting, purging, climate medicine and the miasmatic theory were the fundaments of Western medicine. But then, over the course of just a few decades during the middle of the nineteenth century, they disappeared. Silently, without having been disproven or even disputed, before the breakthrough of bacteriology.In this study I investigate the reasons behind this abandonment, which has been described as ”a precondition for scientific medicine”, using 8800 yearly reports written by 2500 Swedish provincial doctors between 1820 and 1900. These were state funded doctors, based in mostly rural districts throughout all of Sweden. Their tasks included overseeing midwives and vaccinators, inspecting pharmacies, managing epidemics, establishing their own practice and reporting back to the National Board of Health. Their digitised reports constitute a unique source of materials giving direct insight into their conceptions of health and disease.The reports provide evidence that the collapse of ”traditional” medicine should be understood as the result of a decisive break between two different ways of understanding the interaction between body and environment: ”flow-managing” and ”boundary-protecting” medicine. Until the 1860s, the provincial doctors aimed to manage the volume and pace of flows of body fluids. However, between 1865 and 1900, they instead focused on upholding the boundaries between the body and its environment. Doctors stopped understanding bodies as open, fluid, and constantly interacting with the world around them, and rather began perceiving them as closed off, autonomous from and independent of their environment. This shift in what it meant to practice medicine explains the covert but momentous demise of ”traditional” theories and therapies.