Henry E. Sigerist: From the Social Production of Disease to Medical Management and Scientific Socialism

^H w ENRY E. SIGERIST DID MORE THAN ANY OTHER individual to establish, promote, and popularize the history of medicine in America. He made the history of medicine relevant to contemporary concerns and greatly broadened its appeal beyond the small company of scholars, collectors, and amateur gentlemen physicians who had been interested in the field (Miller 1980). As professor of the history of medicine at Johns Hopkins, he made the history of medicine comprehensive, more comprehensible, more significant in human and social terms (Stevenson 1958). Here, I will be concerned with Sigerist's analysis of the social production of disease and its relation to his proposals for the reform of medical care. Sigerist's work on the history of disease has more radical implications than much of his more overtly political writing on the sociology of medicine and medical care organization. Sigerist articulated two, largely distinct, positions in relation to the politics of health and disease. On the one hand, his work on the history of disease suggested that the incidence of disease was generated by social and economic conditions, and therefore had to be addressed by social and economic reorganization, promoted in part by a people's war for health; on the other hand, much of Sigerist's active political and sociological work concentrated on the more limited (if still ambitious) goal of changing the organization, delivery, and financing of health services. Sigerist's dual vision of the physician's role-as participant