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Opinions differ as to whether problem-based learning (PBL) is an effective form of education. Some argue that, contrary to expectation, PBL has failed to promote in students higher levels of knowledge. Others maintain that PBL is a form of minimally guided instruction and therefore less effective and less efficient than instructional approaches that place a stronger emphasis on guidance of the student learning process. This chapter reviews the results of a large number of studies, comparing the performance of medical students and graduates of Maastricht medical school to that of medical students and graduates trained in conventional medical programmes in the same country. The results suggest that students and graduates of the PBL curriculum perform better (1) on tests of diagnostic reasoning, and (2) in the area of interpersonal and (3) medical professional competencies. In addition, (4) students in the problem-based school consistently rate the quality of their education more highly than do students in conventional schools. The same applies to national bodies of experts visiting the schools. Furthermore, the problem-based curriculum (5) turned out to be more efficient and effective, as witnessed by lower dropout and less delay. No differences were found with respect to (6) acquired medical knowledge.

This chapter examines Ayurveda education in India and the reproduction of indigenous knowledge in a pluralist culture. The story of indigenous knowledge systems such as Ayurveda, especially in the last century, has been one of power struggles resisting the authority, prestige, and the hegemonic tendencies of biomedicine, while selectively co-opting the rival’s therapeutic knowledge and practices in order to be relevant and contemporaneous. Today, Ayurvedic education both contests and collaborates with biomedicine, providing an interesting instance of simultaneous reproduction of plural knowledge systems. Contemporary Ayurvedic education raises several questions pertinent to sociology of education (SoE) in India. Having schooled in the biomedical sciences, how do students make the necessary cognitive shift into the Ayurvedic body of knowledge and its conceptual categories? How do modern Ayurveda colleges organize and realize these conceptual shifts and cultural transitions? The author analyses the role of culture in medicine and in education, and describes the educational and cultural processes of knowledge reproduction in the modern institutions of traditional medicine. This chapter also discusses the curricular and extra-curricular strategies used by Ayurveda colleges to address the marginalization of Ayurveda and the dominance of biomedicine. It also considers how Ayurvedic education contests the binaries between two knowledge systems and attempts to counter the power hierarchies ensuing from them.

Diocles of Carystus was perhaps the most important physician in the period between the Hippocratic writers, on the one hand, and Herophilus and Erasistratus, on the other. Diocles was a contemporary of Aristotle — but it is far from clear, and a matter of controversy, whether he was a younger contemporary, let alone a student, of Aristotle. All of Diocles' writings have been lost, but there is a substantial number of fragments and testimonies collected by M. Wellmann in Die Fragmente der sikelischen Ä rzte. This chapter focuses on one sentence in Diocles' fragment, which seems to reflect a position that is radically at variance with a view that is central to Aristotle's conception of science. The sentence in question is this: ‘Furthermore, because many of the things that are (the case) seem in a way like some sort of principles’. The chapter shows that three important Rationalist physicians disagreed with Aristotle in assuming that mere truths of observation and experience form an important part of medical knowledge, properly speaking, but rather that this deviation from Aristotle reflected different views concerning medical knowledge among themselves.

This chapter studies the emergence of Islam, a civilization that found value in previous works and teachings on nature, medicine, and science. It shows that Arab physicians referred to the works of Aristotle and Galen to help improve their science and guide them through medical knowledge and practice. This chapter shows a renewal in anatomical investigation and studies Islamic medicine and science.

This chapter examines the history of medicine in Tibet from the twelfth to seventeenth centuries and its heritage from South Asia, along with its patronage by the Fifth Dalai Lama and his regent, Desi Sangyé Gyatso. A leading light for medicine's growing empirical interests, the Desi was also the mastermind behind the image and power of the new Tibetan Buddhist state, and deeply invested in defending the ultimate authority of a Buddhist episteme. The chapter considers how the Desi was able to defy the normal ethics of deference, how he broached the question of innovation, and how he and the rest of the Dalai Lama's court worked to preserve and advance medical knowledge. It also looks at the Desi's rendition of the life of Zurkharwa Lodrö Gyelpo, sixteenth-century author of the Four Treatises commentary called Ancestors' Advice. Finally, it discusses how medicine and Buddhism are intertwined with the Desi's personal bonds with the Dalai Lama.

This chapter discusses the gentlewomen's practice of creating and collecting medicinal recipes. It looks at the procedures for making a remedy, which constituted the basis of women's pharmaceutical outlook. This chapter also views recipes as a source for medical knowledge. It argues that a medicinal recipe was not necessarily a remedy.

This chapter examines the impact of Song medical texts in medieval Japan and more specifically how they restructured the landscape of knowledge about Japanese medicine. Against a background of the scarcity of Japanese medical works and the plethora of information that became available in a new media as a result of the Song printing revolution, the chapter describes the contours of what is best understood as the appropriating context of Song-period Chinese medicine. It also looks at the variety of Song printed medical works as well as some of the works that Kajiwara Shōzen consulted. Some Chinese medical works are noted in the Ton'ishō and others in the Man'anpō. The chapter concludes by discussing the ways in which Shōzen benefited from Song medical knowledge and how print culture in China helped him become familiar with Song-period Chinese medicine.

This chapter presents an analysis of an essay on anticontagionism and history of medicine. It explains that this essay aims to illustrate how knowledge production and power relations were mutually constitutive or interpenetrated and discusses the social constructivist approach to medical knowledge in the 1970s. It also considers Charles Rosenberg's admission of taking the ingenious course of ignoring the causal and the temporal relationships between material developments and intellectual changes.

This chapter looks at the cultural assumptions that childbearing requires specialised medical knowledge in the United States, where expectant parents usually receive advice on all aspects of pregnancy, childbirth, and infant care from multiple medical experts. This guidance divides the care of mothers and infants under the supervision of separate medical experts, and further fragments various aspects of infant care, including feeding and sleep. The chapter uses historical and ethnographic research to explore the origins of these assumptions and their consequences for American parents who embark on breastfeeding. It suggests that severing the links between these evolutionarily and physiologically connected domains has had a significant detrimental impact on night-time infant care. Parents have been left without adequate community cultural knowledge about the interaction of breastfeeding and sleep, and assume that these processes are separate. As a result, they are frequently surprised by infants' night-time behaviour and have difficulties navigating night-time breastfeeding and sleep. These challenges constitute an important element of an already formidable set of barriers to breastfeeding in the United States, where structural support is extremely limited and breastfeeding remains a controversial practice.

This chapter examines how the attention for Tibetan medicine to the empirical body might have affected the representation of women and gender. The Four Treatises notes that the male body should not be normative for general medicine. In some ways medicine displayed an open view on sexual identity and recognized a third sex, even valorizing its symbolic implications—in stark contrast with the exclusionary restrictions on the third sex in Buddhist monasticism. Some centuries later Zurkharwa Lodrö Gyelpo articulated a category that specifically names gender as distinct from genital anatomy. Yet the Four Treatises also contains strident misogynist passages that echo similar language in Buddhist scriptures, here marshaled in defense of patriliny and patriarchal privilege. In addition to sex and gender, this chapter explores social issues, rhetoric, and contestation in the formation of medical knowledge and how instrumental agendas have affected medical writing in Tibet. It also discusses the response of Tibetan medicine to other Asian medical traditions.

When Robert Koch discovered the cholera microbe in 1884, homeopaths and allopathic physicians staked a claim to his research, attempting to frame this research into a discovery that legitimated their respective systems of medicine. This chapter examines the transformation of Koch's research into a discovery by embedding it within the epistemic contest over medical knowledge.

This book has explored the trajectories of health and disease in the context of poverty by focusing on the experiences of people in low-income neighborhoods in Delhi. It has discussed the clinical encounters between patients and practitioners and has presented the biography of different illnesses in terms of their dispersal over networks of institutions and relationships. It has looked at healers, ranging from practitioners of the occult to those who are certified as licensed practitioners and work in the local medical markets. This concluding chapter considers how we should understand the suspicion against narrations of illness in both literary studies and anthropology. It asks whether we can learn about health and disease in the context of poverty yet also speak to existential concerns about the fragility of everyday life; the place of the patient's experience of his or her illness that gives shape to (or not) to medical knowledge in the clinical encounter; and whether we can speak of the clinical interaction as based on knowledge.

The Japanese are highly educated, extremely health conscious, and feel responsibility for the state of their bodies. Japan is plentifully supplied with physicians, 95 percent of whom are in clinical practice in well-equipped hospitals and clinics, both public and private. However, among the women in the present survey, 60 percent have never talked about kōnenki with a doctor. Whereas they described friends, magazines, and television as reasonably good sources of information, only about 25 percent of the sample said that they had received useful information from their physician. At present, many thoughtful people struggle with a dilemma: to assert that Japanese women's experience at the end of menstruation is somewhat different from what the scientific literature accepts as normal. And yet to follow without reservations behind current scientific authority on menopause is experientially counterintuitive.

This chapter focuses on the acquisition and circulation of indigenous medical knowledge within the Portuguese colonial empire. First, it examines the role and influence of medical techniques, remedies, and drugs originating from colonial holdings in Asia, Africa, and the Americas. It then discusses the dissemination of healing techniques and trade of medicinal plants across Europe and contemporary Dutch, English, French, and Spanish maritime enclaves.

This chapter examines the emergence of wound medicine as a medical specialty in response to the eruption of violence and warfare in Japan in the early fourteenth century, with particular emphasis on factors that shaped the availability and reception of Song medical knowledge. It begins by discussing the new warfare environment from the 1330s that arose after the destruction of the Kamakura bakufu. It then provides an overview of wound medicine prior to the 1330s and goes on to consider sources of knowledge for wound medicine, along with various items of materia medica mentioned in wound medicine texts such as Sanyin fang. It also explores how Song-era Chinese medicine influenced Japanese wound medicine. The chapter shows that physicians in medieval Japan gained experience in treating wounds by extrapolating from generic knowledge and that Song medicine provided—courtesy of Sanyin fang—a conceptual basis for wound medicine where one did not exist before.

This epilogue offers a number of broader observations relating to the appropriation, testing, and refining of Song medical knowledge by focusing on Kajiwara Shōzen. It first considers some issues related to the transmission and appropriation of book knowledge and some of the things that Shōzen gained from Song-era Chinese medicine. It then explores issues relevant to the clinical engagement of that new knowledge and describes the process of inquiry. It also discusses the interaction of Buddhist and Chinese systems of explanation, citing an example where Song medicine was confirmed by reference to a Buddhist understanding and another example where Buddhist understanding was superseded by a Chinese understanding. For Shōzen, the major explanatory challenge involving karma related to rai; despite the notion of karma being so fundamental to Buddhism, he concluded that a Song medical explanation was a superior model for a disease that had been previously understood in terms of basic Buddhist textual teaching.