While the history of medicine is incredibly interesting, it is, in equal parts, entirely horrifying. In the past, everything from bloodletting, to the boring of holes into the skull, have been prescribed widely by medical practitioners. As we look back, it’s easy to consider these practices savage, but in their time, they were considered the highest standard of care. These failures in medicine go beyond treatments to the diagnostics that guide them.
The above video gives some insight into where early diagnoses came from and how practitioners were educated.
While some diagnoses were developed with patient health in mind, others were developed for the purpose of control.
An example of this comes in the form of an 1897 diagnosis of “bicycle face“ written about in the National Review by Dr. Shadwell. This diagnosis was a measure hoping to discourage women from cycling, citing medical reasons. In his article, “The Dangers of Cycling “ Shadwell describes a strained facial expression as the main symptom of the disorder. This, he alleged, was the result of too much cycling, which over time was harmful to a woman’s appearance and desirability.
While the diagnosis might seem funny today, it likely removed a healthy addition and convenient mode of transportation from the lives of many women. Additionally, it was undoubtedly an effort to reduce independence in women of the time.
In 19th century America, other invented conditions were used to control and justify the mistreatment of victims of slavery. Fictitious mental conditions were created with symptoms including laziness and an unlikelihood to follow orders. Lesions on the skin were also considered a symptom, although this was likely to help cover up abuse from slave owners. For the treatment of this condition, doctors recommended whipping.
More recently, we battle different harmful diagnoses. For example, homosexuality was still defined in DSM-1 as a “sociopathic personality disturbance.“ Shockingly, just last year, the WHO updated their International Classification of Diseases manual to no longer define transgender individuals as disordered.
These examples highlight how regularly questioning our understanding of medicine is essential for providing a high standard of care.
To avoid the use of diagnosis to justify harmful practices, like conversion therapy, we need to be ever vigilant about the quality and implications of the diagnoses we hand down.