Documenting and Describing. The Epistemic Function of Psychiatric Records, their Archiving and Reinterpretation into Case Histories. The paper attempts to reconstruct the writing of published case histories. Due to the establishment of a scientific classification system in psychiatry there were at the Charité several changes from the late 1870s onwards: (1) Not only was the documentation in the clinical records altered significantly, but also (2) the archive was reorganized into a double filing system and (3) the casuistic made a development (...) from describing seldom or sensational cases into a mode which aimed to unfold psychiatric theory through ‘typical cases’. Original medical records, the internal documentation of psychiatric observation, will be compared to their published version. Both, the narrative of a case study and the documentation in the clinical records reveal performative processes of observation and documentation. (shrink)

Among the many groups of scholars whose work now illuminates science, technology and medicine (STM), historians, it seems to me, have a key responsibility not just to elucidate change but to establish and explain variety. One of the big pictures we need is a model of the varieties of STM over time; one which does not presume the timeless existence of disciplines, or the distinctions between science, technology and medicine; a model which is both synchronic and diachronic, and both cognitive (...) and social. To that end, this brief paper presents a historical typology of STM from about 1700 to the present by focusing on four ‘ideal’ socio-cognitive types – four knowledge structures which correspond to four sets of social relations. To some extent these are period specific, but they do not have to be – hence, one may hope, the flexibility and usefulness of the model. (shrink)

Performing Madness: The Clinic as Stage. In the second half of the nineteenth century, clinical demonstrations became the dominant teaching method in psychiatry, playing a key role in medical‐professional disputes, as well. This paper traces this widely used though historiographically neglected practice of knowledge implementation and mediation, as demonstrated in the psychiatric clinic of the Berlin Charité (Psychiatrische und Nervenklinik der Berliner Charité) from 1881 to 1927. Documentation of this practice, found within individual medical records, forms the basis of this (...) research. The concept of ‘theatricality’ assists in uncovering the dramatic quality of the clinical demonstration: Psychiatric knowledge was not simply disseminated through such a practice; rather, such knowledge was first performatively created through the very logic of its presentation of exemplary patient histories, as well as through the examination and diagnostic positioning of its patients. The ‘success’ of such presentations depended on many variables, related to staff, time, place, and other situational factors. These include the presence of appropriate lecture halls, the availability and calculated selection of patients, and the employment of specific performative techniques by doctors for the sake of producing desired results. As one effect, clinical demonstrations also encouraged patients to both learn and rehearse behavior considered relevant to the particular diagnosis that was to be demonstrated. (shrink)