Refining a History of Medicine Research Topic

Dawna M Gilchrist, MD FRCPC FCCMG DHMSA

Medical trainees and practitioners often have difficulty visualizing a topic of research in history of medicine. The initial concern is that doing history of medicine research is totally different than doing medical research. The history research question may be framed in different terminology. History research methods and materials may be quite different. However, the basic process is the same: Ask a question; answer it.

The starting point is most critical. It is important that a clear question is asked. And, that the research is ‘doable’ in terms of time frame and available resources. For example, you shouldn’t consider ‘alternative medicine’ a researchable topic unless you are prepared to write a book (or several). As in the vast majority of any research project, one needs to be focused on a specific aspect of the area of interest.

As my original training was in internal medicine, I approach most medical problems in terms of the differential diagnosis. For example, every internist knows that ‘heart failure’ is a symptom complex and there are dozens of potential causes. If one tries to list all the possible causes without a method, it can be confusing; the generated list will be disorganized and incomplete. However, if one thinks of the differential diagnosis as a tree, with a logical progression from the tree trunk (heart failure) through major branches (congestive, restrictive, constrictive), through ever smaller branches (including right/left/bi, pathophysiological mechanism, inherited/acquired ) then one can add many more ‘leaves’ with surety. For example, hemochromatosis is a congestive, biventricular, metabolic, inherited cause of heart failure.

If you apply the ‘differential diagnosis’ approach to focusing a history of medicine research project, start with the tree trunk – ‘alternative medicine’. Major and intermediate branches can be constructed in many ways – temporal followed by geography (or vice versa). One can then look at specific practitioners or movements eg. Mesmerism, naturalism. One may then focus on specific small branches or leaves of the tree. For example: alternative medicine – 19th century – North America – Graham and Grahamites – graham wafer crackers. Now there’s a good research topic for a medical student – “how did graham wafers start out as a health food?”

Just because History of Medicine is in the ‘Arts” does not mean that research in history of medicine topics is less rigorous than research in the lab or in the clinic. ASK A QUESTION; ANSWER IT. But, first start with an appropriate focus.