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Searching for the Patient’s Presence in Medical Case Reports


Magdalena Zabielska

The book addresses the issue of the patient’s presence in specialist medical publications in the context of a patient-centered approach to medical practice. The author combines both quantitative and qualitative approaches in order to analyze the discourse about the patient in one of the oldest medical genres, case reports. She traces textual references to patients throughout the reports to show that their nature and frequency depend both on the structure of the genre and the context of the production of these texts. The author touches upon the topical issue that although specialist communication may seem to exclude patients, it does not mean it does not concern them. Indeed, they are written about and it appears critical how this is done.
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Chapter Two: Medical discourse and case reports from a historical perspective


Anyone temped to study the history of medicine from the early beginnings to its current status will be impressed by its progress and what it has to offer to humankind at present. There are milestones in the history of medicine which made its development possible. However, this section will be restricted only to those facts which are relevant to the aims of the work. In detail, account will be made only of those events which directly or indirectly exerted influence on patient imaging in medical discourse generally and in case reports specifically, as, following Bazerman (1988), scientific discourses are conditioned by given disciplines. Consequently, it will be demonstrated how scientific discoveries and intellectual trends in medicine shaped the modes of patient presentation.

The practice of recording cases of diseases has its roots in Hippocrates’ (ca. 460 BC – ca. 370 BC) medical writings. Harriet Nowell-Smith (1995: 49–50) and Brian Hurwitz (2006: 219–220) note that his case histories dealing with diseases in individual people were finely composed and followed the sequence of events. Moreover, as Hurwitz (2006) observes, Hippocratic case histories were characterized by close attention to detail when it came to describing the patient’s body. “Hippocratic preoccupation with external appearances, signs, surfaces, and colors created a visual primacy that eventually culminated in our own times in the capacity to visualize the body from remarkable new technological vantage points” (2006: 218). Furthermore, Roberto Margotta (1996: 27) observes that it was Hippocrates’ belief that doctor’s duty is to relieve...

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