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Volume 10, Issues 1 & 2 (2025)

Special dual-issue publication exploring foundational paradigm shifts in historical medical practice, epistemological foundations of clinical philosophy, and contemporary intersections of medical humanities and digital healthcare ethics.

Issue 1 (2025)

7 Articles

Research Article Pages: 1–24

The Epistemological Evolution of Clinical Nosology in Enlightenment Vienna

Eleanor Vance¹, Marcus Sterling²

History of Medicine Nosology Enlightenment Vienna

Abstract

The systematic classification of diseases underwent a radical transformation during the second half of the eighteenth century within the clinical environment of the Viennese medical school. This paper investigates the epistemological shifts that occurred as physicians transitioned from traditional humoral pathology to empirical, bedside-oriented nosological taxonomies inspired by botanical classification systems of the period. By analyzing institutional records, case books from the Allgemeine Krankenhaus, and rare pedagogical treatises, we demonstrate how Gerard van Swieten and Anton de Haen synthesized quantitative bedside observation with rigorous anatomical taxonomy. Furthermore, we examine the philosophical tensions between speculative medical systems and emergent empirical reductionism, highlighting how Enlightenment ideals of rational statecraft directly influenced public health classifications and hospital organization. Our findings suggest that Viennese nosology was not merely a clinical filing system, but a profound philosophical project aimed at rendering human suffering intelligible, governable, and ultimately curable through standardized empirical observation.

Keywords

History of Medicine; Nosology; Enlightenment Vienna; Gerard van Swieten; Medical Epistemology; Clinical Taxonomy.

Author Affiliations

¹ Department of History of Science and Medicine, University of Oxford, United Kingdom.
² Institute for Philosophy and Ethics of Medicine, Ludwig Maximilian University of Munich, Germany.

Review Article Pages: 25–48

Moral Therapy and the Asylum: Spatial Politics of Mental Health in Nineteenth-Century Britain

Arthur Pendleton¹, Beatrice Duval²

Medical Humanities Psychiatry Asylum History

Abstract

The emergence of moral therapy in nineteenth-century British psychiatry represented a profound shift in both the conceptualization of madness and the architectural design of therapeutic environments. This article explores how reformers such as William Tuke and John Conolly conceptualized the lunatic asylum not merely as a custodial institution, but as a therapeutic instrument itself—a structured moral universe engineered to restore internal psychological equilibrium through rational order, labor, and gentle discipline. By conducting a comparative spatial analysis of early Quaker retreats and subsequent county asylums, we examine how spatial architecture, landscape gardening, and domestic interior design were weaponized as non-pharmacological interventions. However, we also critically interrogate the paradoxes inherent in moral management, revealing how benevolent surveillance frequently blurred into rigid social control and disciplinary coercion. Ultimately, this study contributes to the critical philosophy of psychiatry by demonstrating how nineteenth-century architectural and therapeutic frameworks prefigured modern debates surrounding autonomy, institutionalization, and therapeutic coercion in mental healthcare.

Keywords

Moral Therapy; Asylum Architecture; History of Psychiatry; Nineteenth-Century Britain; Surveillance; Medical Humanities.

Author Affiliations

¹ Centre for Medical History and Culture, University of Edinburgh, Scotland.
² Department of History of Science, Sorbonne Université, Paris, France.

Research Article Pages: 49–72

Phenomenology of Pain in Early Modern Surgical Treatises: From Anatomie to Paré

Céline Leroi¹, Julian Voss²

Philosophy of Medicine Surgical History Pain Studies

Abstract

Before the advent of anesthesia in the mid-nineteenth century, physical pain was an inevitable, immediate companion to surgical intervention. This paper examines how early modern European surgeons, most notably Ambroise Paré and his contemporaries, conceptualized, communicated, and attempted to mitigate patient pain within their vernacular and Latin surgical treatises. Employing a phenomenological hermeneutic, we analyze how sixteenth-century texts constructed a vocabulary of suffering that bridged humoral theory and practical manual dexterity. Surgeons were tasked with balancing the imperative to heal against the visceral reality of iatrogenic agony, leading to sophisticated rhetorical strategies in case narratives designed to validate the patient’s subjective experience while asserting the clinician's therapeutic authority. We further investigate how pharmacological opiates, herbal narcotics, and psychological fortitude were framed within philosophical discussions of human endurance. Our analysis reveals that early modern surgical literature contained an implicit philosophy of bodily vulnerability, wherein pain was understood not merely as a physiological symptom, but as a profound existential test of human resilience and professional skill.

Keywords

Pain Phenomenology; Early Modern Surgery; Ambroise Paré; Philosophy of Medicine; History of Anatomy; Surgical Ethics.

Author Affiliations

¹ Department of Philosophy, Université de Genève, Switzerland.
² Institute for History of Medicine, Charité Universitätsmedizin Berlin, Germany.

Research Article Pages: 73–96

Biopolitics of Vaccination Mandates: Smallpox Inoculation in Eighteenth-Century Continental Debate

Hannah Moore¹, Gideon Cross²

Medical Humanities Biopolitics Public Health History

Abstract

The introduction of variolation (smallpox inoculation) and subsequent Jennerian vaccination sparked some of the most intense bioethical and political controversies in Western history long before contemporary immunization debates. This article explores the philosophical and political arguments surrounding state-sponsored and mandated inoculation in eighteenth-century Europe and its colonial peripheries. Drawing upon archival tracts, theological sermons, and early statistical polemics by figures such as James Jurin and Charles Marie de La Condamine, we analyze the collision between individual bodily autonomy and sovereign state interests in epidemic management. Critics frequently framed compulsory inoculation as an infringement upon divine providence and personal liberty, whereas proponents argued from an early utilitarian framework, calculating collective risk versus individual hazard. By reframing these debates through Foucaultian lenses of biopower and governmentality, we demonstrate how eighteenth-century smallpox controversies established the foundational vocabulary for modern public health mandates, risk communication, and citizen compliance.

Keywords

Smallpox Inoculation; Biopolitics; Public Health History; Eighteenth-Century Philosophy; Vaccination Mandates; Risk Ethics.

Author Affiliations

¹ Department of History, Harvard University, Cambridge, MA, USA.
² Institute for Ethics and History of Medicine, University of Zurich, Switzerland.

Research Article Pages: 97–118

The Philosophical Foundations of Holism in Interdisciplinary Twentieth-Century Medicine

Sylvia Harrison¹, Nathaniel Drake²

Philosophy of Medicine Twentieth-Century History Holistic Medicine

Abstract

In an era dominated by rapid technological reductionism and laboratory specialization, twentieth-century medicine frequently witnessed powerful counter-movements advocating for holistic and organismic approaches to patient care. This article traces the philosophical lineage of medical holism from Jan Smuts' original formulation of holism through to mid-century clinician-philosophers such as Francis Peabody, Viktor von Weizsäcker, and George Engel. We examine how these thinkers reacted against the fragmentation of the biomedical model by proposing psychosomatic and biopsychosocial frameworks that restored the patient's lived context, biographical narrative, and social environment to the center of clinical epistemology. By analyzing pivotal manifestos and clinical journals from the interwar period onward, we explore the epistemological tensions between mechanistic laboratory science and holistic clinical judgment. Our study argues that medical holism was never merely a romantic or anti-science sentiment, but a sophisticated epistemological critique aimed at redefining disease not as a localized biological malfunction, but as a systemic perturbation of the total human organism in its environment.

Keywords

Medical Holism; Biopsychosocial Model; Twentieth-Century Medicine; Philosophy of Science; Viktor von Weizsäcker; Clinical Epistemology.

Author Affiliations

¹ Department of History and Philosophy of Science, University of Cambridge, UK.
² Institute for Medical Humanities, Johns Hopkins University, Baltimore, MD, USA.

Research Article Pages: 119–142

Gender and Hysteria in Late Nineteenth-Century Medical Illustration: The Charcot Iconographic Legacy

Beatrice Oliver¹, Victorine Lambert²

Medical Humanities Gender Studies Iconography

Abstract

The visual culture of medicine at Jean-Martin Charcot’s Salpêtrière hospital in Paris remains one of the most powerful intersections of clinical authority, gender representation, and photographic technology in nineteenth-century history. This article investigates the production and dissemination of the multi-volume *Iconographie photographique de la Salpêtrière*, examining how photographic plates constructed the visual archetype of hysterical pathology. By combining art history, feminist philosophy, and the history of psychiatry, we analyze the performative dynamics between clinical demonstrators and female patients whose bodily contortions were captured, classified, and broadcasted across European scientific circles. We argue that these visual representations operated within a deeply gendered patriarchal framework that pathologized female emotional expression while simultaneously staging hysteria as an aesthetic spectacle. Our analysis illuminates how medical photography served as an epistemological tool that legitimized neurological claims through visual evidence, permanently altering the historical relationship between medical observation, gender identity, and artistic representation.

Keywords

Hysteria; Jean-Martin Charcot; Medical Illustration; Salpêtrière; Gender History; History of Psychiatry.

Author Affiliations

¹ Department of Art History and Medical Humanities, University of Toronto, Canada.
² Institut d'Histoire de la Médecine, Université de Strasbourg, France.

Research Article Pages: 143–165

From Miasma to Microbe: Bacteriological Revolution and Philosophical Shifts in Sanitary Reform

Oliver Twist¹, Elena Rostova²

History of Medical Sciences Bacteriology Sanitary Reform

Abstract

The transition from miasmatic contagion theories to germ theory in the late nineteenth century is frequently celebrated as a straightforward triumph of laboratory science over archaic superstition. However, this paper argues that the bacteriological revolution instigated a profound ontological and political crisis in public health philosophy. While miasmatic sanitary reformers like Edwin Chadwick prioritized holistic environmental cleanliness—focusing on urban ventilation, sewage removal, and atmospheric purity—the subsequent triumph of Pasteur’s and Koch’s bacteriology redirected focus toward specific microbial agents and targeted immunological interventions. Through an examination of sanitary committee debates in London, Berlin, and St. Petersburg, we explore how this paradigm shift altered the conceptualization of disease etiology and redefined the responsibilities of the sanitary state. We demonstrate that while bacteriology enabled unprecedented precision in infectious disease control, it also fostered a reductive technocratic individualism that frequently neglected broader socio-economic determinants of health, a philosophical tension that continues to resonate in contemporary epidemiological debates.

Keywords

Miasma Theory; Germ Theory; Bacteriological Revolution; Sanitary Reform; History of Epidemiology; Public Health Philosophy.

Author Affiliations

¹ Department of History of Medicine, Imperial College London, UK.
² Institute for Philosophy and History of Science, Saint Petersburg State University, Russia.

Issue 2 (2025)

8 Articles

Research Article Pages: 1–28

Ethics of Experimentation Without Consent: Historical Case Studies from the Interwar Clinical Trials

Sebastian Ward¹, Clare Montgomery²

Medical Ethics Clinical Trials Interwar History

Abstract

The codification of informed consent in contemporary biomedical research is frequently framed as a direct post-World War II reaction to Nazi atrocities. However, historical examination reveals that ethical debates regarding human experimentation without explicit consent were already fiercely contested during the interwar period (1918–1939) across European and American research hospitals. This paper explores the institutional protocols, professional guidelines, and public scandals surrounding clinical trials involving vulnerable populations—including orphanage residents, psychiatric patients, and impoverished clinic attendees—prior to the formulation of the Nuremberg Code. By examining archival correspondence from academic medical centers and Prussian state health directives of 1900 and 1931, we uncover an earlier, nascent regulatory framework that sought to balance the advancement of therapeutic science against patient bodily integrity. Our analysis illuminates how clinical paternalism and utilitarian justifications for human testing persisted within mainstream academic medicine long before international human rights frameworks were established.

Keywords

Informed Consent; Human Experimentation; Medical Ethics History; Interwar Clinical Trials; Vulnerable Populations; Research Ethics.

Author Affiliations

¹ Kennedy Institute of Ethics, Georgetown University, Washington, DC, USA.
² Department of History and Ethics of Medicine, King's College London, UK.

Research Article Pages: 29–52

The Concept of "Normal" in Canguilhem and Its Medical Implications for Contemporary Pathology

Lucas Fabian¹, Sophie Marceau²

Philosophy of Medicine Canguilhem Normativity

Abstract

Georges Canguilhem’s seminal work *The Normal and the Pathological* fundamentally challenged the reductionist assumption that disease is merely a quantitative variation from a statistical norm. This article re-evaluates Canguilhem’s philosophical framework in light of contemporary genomics, personalized medicine, and big data diagnostics. We investigate his assertion that biological normativity is grounded in the living organism’s capacity to institute norms across varying environments, rather than in static physiological averages established by statistical medicine. By analyzing how modern predictive algorithms and biomarker thresholds redefine health and pathology, we argue that contemporary biomedical technology frequently resurrects the exact statistical determinism that Canguilhem critiqued. Our analysis provides a robust philosophical defense of normative flexibility, suggesting that clinical philosophy must integrate subjective vital norms alongside objective quantitative metrics to adequately understand human health in the twenty-first century.

Keywords

Georges Canguilhem; Normal and Pathological; Biological Normativity; Philosophy of Medicine; Statistical Health; Diagnostic Algorithms.

Author Affiliations

¹ Department of Philosophy, Université Paris 1 Panthéon-Sorbonne, France.
² Centre for Ethics in Biomedicine, KU Leuven, Belgium.

Research Article Pages: 53–78

Herbal Medicine and Humoral Theory in Islamic Medical Manuscripts of the Mediterranean Basin

Tariq Al-Mansoor¹, Miriam Sterling²

History of Medical Sciences Islamic Medicine Pharmacology

Abstract

The synthesis of Greco-Roman pharmacological texts with Persian, Indian, and indigenous Arabian medical traditions during the Islamic Golden Age generated an extraordinarily rich corpus of materia medica. This article examines illustrated medieval Arabic and Andalusian medical manuscripts, focusing on the categorization of botanical remedies according to the doctrine of humoral qualities (hot, cold, wet, dry) and degrees of potency. By analyzing pharmacopeias authored by figures such as Ibn Sina (Avicenna), Al-Zahrawi, and Ibn al-Baitar, we investigate how physicians systematically tested, classified, and synthesized botanical compounds for clinical application across hospitals in Baghdad, Cairo, and Cordoba. We explore the sophisticated empirical methodologies embedded within these texts, which prefigured modern pharmacological testing and standardization. Our findings emphasize that medieval Islamic pharmacology was not merely a passive repository of classical antiquity, but an active, empirically driven science that deeply shaped European Renaissance medicine and modern pharmacognosy.

Keywords

Islamic Medicine; Humoral Theory; Materia Medica; Ibn Sina; Medieval Pharmacology; History of Medical Sciences.

Author Affiliations

¹ Department of History of Islamic Science, American University of Beirut, Lebanon.
² Institute for Near Eastern Studies, Freie Universität Berlin, Germany.

Review Article Pages: 79–102

The Narrative Turn in Clinical Practice: Medicine, Literature, and the Ethics of Empathy

Nora Vanderbilt¹, Matthew Hayes²

Medical Humanities Narrative Medicine Clinical Empathy

Abstract

Over the past three decades, the rise of narrative medicine has championed the integration of literary theory and close reading into medical education and clinical encounters. This article critically examines the philosophical underpinnings of the "narrative turn" in modern healthcare, evaluating how storytelling, illness narratives, and literary empathy serve as counterweights to hyper-technological biomedical reductionism. Drawing upon phenomenological aesthetics and virtue ethics, we analyze how training clinicians in narrative competence enhances diagnostic attentiveness, patient-physician rapport, and ethical decision-making. However, we also interrogate potential pitfalls, including the risk of sentimentalizing patient suffering, the institutional instrumentalization of empathy as an administrative tool, and the structural constraints of managed care that squeeze out narrative time. Our study concludes with a call for a critically reflexive narrative medicine that acknowledges both the therapeutic power of stories and the stubborn material realities of bodily disease.

Keywords

Narrative Medicine; Medical Humanities; Clinical Empathy; Illness Narratives; Bioethics; Medical Education.

Author Affiliations

¹ Program in Narrative Medicine, Columbia University Vagelos College of Physicians and Surgeons, NY, USA.
² Department of Medical Humanities, King's College London, UK.

Research Article Pages: 103–126

Radium Madness and Occupational Health Regulation in the Roaring Twenties

Claire Dubois¹, Harrison Reed²

History of Medical Sciences Occupational Health Toxicology

Abstract

The discovery of radioactivity heralded an era of intense commercial infatuation, leading to the widespread addition of radium to consumer products, patent medicines, and industrial paints. This article examines the tragic history of the "Radium Girls"—factory workers who ingested lethal doses of radioactive paint while pointer-painting watch dials in New Jersey and Illinois during the 1920s—and analyzes how industrial poisoning forced a radical revision of occupational health standards. We investigate the fierce scientific and legal battles waged between corporate lobbyists, independent toxicologists, and pioneering medical researchers such as Alice Hamilton and Harrison Martland. By examining laboratory reports, coroner inquests, and corporate correspondence, we demonstrate how industrial capitalism systematically suppressed emerging toxicological evidence until catastrophic public health scandals made suppression untenable. This historical case study highlights the enduring ethical tensions between corporate profit and worker safety, establishing vital precedents for modern radiation protection and occupational safety regulation.

Keywords

Radium Girls; Occupational Health; Industrial Toxicology; History of Medicine; Alice Hamilton; Radiation Safety.

Author Affiliations

¹ Department of History of Science, Princeton University, NJ, USA.
² Institute for Occupational Health and Medicine, McGill University, Montreal, Canada.

Research Article Pages: 127–150

Epistemology of Psychiatric Diagnosis from DSM-I to DSM-5: A Philosophical Critique

Greta Vance¹, Damian Cross²

Philosophy of Psychiatry DSM History Epistemology

Abstract

The evolution of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) represents one of the most consequential methodological projects in modern medical history. This paper provides a rigorous philosophical critique of the epistemological transformations that occurred from the psychoanalytically informed DSM-I (1952) through to the neo-Kraepelinian, phenomenologically neutral checklists of DSM-III and DSM-5. We investigate the philosophical assumptions underpinning operationalized diagnostic criteria, examining how the quest for inter-rater reliability inadvertently fostered ontological reification—treating theoretical diagnostic constructs as discrete, natural disease entities. Drawing upon Ian Hacking’s concept of "making up people" and philosophical discussions of natural kinds, we explore the social and clinical consequences of psychiatric classification. Our analysis concludes that contemporary psychiatric nosology requires a pluralistic epistemological framework that integrates dimensional psychopathology, patient narrative, and neurobiological mechanisms to avoid the pitfalls of categorical reductionism.

Keywords

Psychiatric Diagnosis; DSM-5; Philosophy of Psychiatry; Epistemological Critique; Natural Kinds; Ian Hacking.

Author Affiliations

¹ Department of Philosophy and Psychiatry, King's College London, UK.
² Institute for History and Philosophy of Science, University of Sydney, Australia.

Research Article Pages: 151–174

The Plague Chronicles of Medieval Europe: Between Divine Retribution and Early Epidemiological Tracking

Julian Mercer¹, Beatrice Faye²

History of Medicine Medieval History Epidemiology

Abstract

The onset of the Black Death in 1347 fractured medieval European society, prompting an intellectual scramble to interpret and contain an apocalyptic pandemic that defied existing medical paradigms. This article investigates contemporary chronicles, municipal quarantine decrees, and medical faculty consilia (such as the famous Paris Medical Faculty report of 1348). We explore the complex cognitive dualism that characterized medieval responses: while theologians and chroniclers frequently framed pestilence as divine retribution for human sin, municipal authorities and plague doctors implemented remarkably sophisticated pragmatic quarantine protocols, cordoning measures, bill-of-mortality tracking, and sanitary inspections. By analyzing these primary sources, we demonstrate that medieval plague management was not purely obscurantist, but contained the nascent empirical foundations of public health surveillance and epidemiological tracking. Our findings bridge the gap between religious worldviews and early scientific empiricism in medieval healthcare history.

Keywords

Black Death; Medieval Medicine; Plague Chronicles; Quarantine History; Epidemiological Tracking; Divine Retribution.

Author Affiliations

¹ Centre for Medieval Studies, University of York, UK.
² Department of History of Science, Università di Bologna, Italy.

Review Article Pages: 175–198

Artificial Intelligence in Clinical Decision-Making: Epistemological and Ethical Challenges in Contemporary Medicine

Arthur Pendleton II¹, Christina Wu²

Medical Humanities AI Ethics Clinical Philosophy

Abstract

The rapid integration of machine learning algorithms and artificial intelligence into clinical diagnostics and therapeutic planning represents the latest and perhaps most profound epistemological rupture in modern medicine. This article provides a comprehensive philosophical critique of AI-driven clinical decision support systems, examining the black-box problem, opacity of algorithmic reasoning, and the erosion of traditional clinical phronesis (practical wisdom). We analyze how algorithmic reliance on retrospective big data datasets can perpetuate historical healthcare biases, reify systemic inequalities, and transform clinicians from empathetic decision-makers into passive operators of automated systems. Drawing upon virtue ethics and philosophy of science, we evaluate the ethical implications of delegating moral responsibility for patient outcomes to non-conscious computational artifacts. Our study concludes by proposing an ethical framework for human-AI collaboration in healthcare that preserves clinician accountability, patient autonomy, and the irreplaceable role of interpersonal empathy in medical practice.

Keywords

Artificial Intelligence; Clinical Decision-Making; AI Ethics; Medical Epistemology; Black Box Problem; Phronesis.

Author Affiliations

¹ Oxford Uehiro Centre for Practical Ethics, University of Oxford, UK.
² Department of Digital Health and Medical Ethics, Stanford University, CA, USA.

Volume 10, Issues 1 & 2 (2025)

Issue 1 (2025)

The Epistemological Evolution of Clinical Nosology in Enlightenment Vienna

Abstract

Keywords

Author Affiliations

Moral Therapy and the Asylum: Spatial Politics of Mental Health in Nineteenth-Century Britain

Abstract

Keywords

Author Affiliations

Phenomenology of Pain in Early Modern Surgical Treatises: From Anatomie to Paré

Abstract

Keywords

Author Affiliations

Biopolitics of Vaccination Mandates: Smallpox Inoculation in Eighteenth-Century Continental Debate

Abstract

Keywords

Author Affiliations

The Philosophical Foundations of Holism in Interdisciplinary Twentieth-Century Medicine

Abstract

Keywords

Author Affiliations

Gender and Hysteria in Late Nineteenth-Century Medical Illustration: The Charcot Iconographic Legacy

Abstract

Keywords

Author Affiliations

From Miasma to Microbe: Bacteriological Revolution and Philosophical Shifts in Sanitary Reform

Abstract

Keywords

Author Affiliations

Issue 2 (2025)

Ethics of Experimentation Without Consent: Historical Case Studies from the Interwar Clinical Trials

Abstract

Keywords

Author Affiliations

The Concept of "Normal" in Canguilhem and Its Medical Implications for Contemporary Pathology

Abstract

Keywords

Author Affiliations

Herbal Medicine and Humoral Theory in Islamic Medical Manuscripts of the Mediterranean Basin

Abstract

Keywords

Author Affiliations

The Narrative Turn in Clinical Practice: Medicine, Literature, and the Ethics of Empathy

Abstract

Keywords

Author Affiliations

Radium Madness and Occupational Health Regulation in the Roaring Twenties

Abstract

Keywords

Author Affiliations

Epistemology of Psychiatric Diagnosis from DSM-I to DSM-5: A Philosophical Critique

Abstract

Keywords

Author Affiliations

The Plague Chronicles of Medieval Europe: Between Divine Retribution and Early Epidemiological Tracking

Abstract

Keywords

Author Affiliations

Artificial Intelligence in Clinical Decision-Making: Epistemological and Ethical Challenges in Contemporary Medicine

Abstract

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Author Affiliations

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