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Sample Book Proposals
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Following are examples of two successful book proposals. "Writing in Cyberspace," by Moira Allen, was submitted to Allworth Press in 1998, and became the book Writing.com: Creative Intenet Strategies to Advance Your Writing Career (first edition 1999, second edition May 2003; now out of print).
"A Medical History Textbook" was proposed by Robin Anderson to Prentice-Hall in January 2003; the book is currently in the contract stage (as of April 2003). Although this is an academic textbook, the proposal demonstrates the basic requirements of a successful pitch for any nonfiction book, including an excellent chapter-by-chapter summary. [Update: Thus far the outcome of this proposal was a contract for a second book: a medical history reader. The first book was ultimately not accepted.]
Due to the constraints of HTML, the format of these proposals is not precisely as they appeared originally (in Word), but is a sufficient approximation (and adequate as an overall guide to proposal format).
Neither of these proposals include "author credentials," as these were submitted separately in both cases.
WRITING IN CYBERSPACE
Overview and Rationale
What do writers want to know about the Internet?
For most, the answer is not "how to get connected" or "how to use e-mail." Nor is it "what's out there," although writers are always interested in new resources. What writers want to know is "how do I use it?" Specifically, writers want to know how to use the Internet to improve productivity, find research material quickly and easily, increase markets and sales, and improve their writing skill.
The Internet is changing the way writers do business, not only with electronic media but also with traditional print markets. It is changing the rules -- and writers of every level of experience, from beginner to seasoned professional, are asking the same questions:
These questions haven't been addressed either by traditional writing books (which still provide little information about the Internet) or by existing "writer's guides" (which either focus on introductory basics or on lists of resources). Writers are eager for material that will help them write and sell more effectively -- material that not only tells them what is available on the Internet, but how to use it.
- How will the Internet affect my future as a writer?
- How can I use it to locate new markets and increase sales?
- How can I build better research skills so that I can find what I want more quickly?
- How can I find a good online writing or critique group?
- When is it appropriate to use electronic queries, and how do they differ from traditional queries?
- How do I format a manuscript for electronic submissions?
- Do I have to learn to write "differently" for e-zines and electronic publications?
- How will the international nature of the Internet affect and improve my business?
- Am I in danger of losing my copyright if I post material on-line?
- How can I build a Web site that will increase my visibility and reputation?
- Should I "self-publish" my work on-line?
Writing in Cyberspace is designed to answer these questions, and more. It is divided into three sections that correspond with the way most writers "experience" the Internet: Exploration (research), Interaction (using e-mail and networking), and Creation (establishing an on-line presence). Each chapter highlights a particular aspect of the writing business and how that aspect has been affected (or can be improved) by the Internet.
Writers will find the Resource Appendix particularly useful. This appendix doesn't simply list sites by name, but divides them into categories and provides a brief description of each site. It focuses upon the use of "jump sites" -- data sites that provide links to a particular topic or subject area. For example, instead of listing individual author Web sites, the Cyberspace Resource Appendix will take the reader to central "author directory" sites from which the reader can then search for authors by name or genre. The Resource Appendix will list not only important writing-related sites, but key "jump sites" in various research categories.
Writing in Cyberspace is written from the perspective of a writer. It asks the questions writers ask, and answers them with the information writers need to improve their sales and their skill. It dispels many of the myths that have surrounded the Internet ("It will replace books and make writers obsolete!") and demonstrates a host of new opportunities for writing success in the 21st century.
Writing in Cyberspace is like no other guide to the Internet. Instead of focusing upon Internet basics or providing lists of resources, Cyberspace emphasizes applications and "how-to's." Its three sections -- Exploration, Interaction, and Creation -- correspond to way most writers experience the Internet, beginning with research and moving on to Web site development.
Chapter One: Reshaping the Future
The Internet is changing the future for writers. It is opening new opportunities, including markets that will enable a writer to be "heard" around the world. It is also changing the rules -- which is a source of tension for many writers, who have traditionally been taught never to break those rules. This chapter will cover:
Part I: Exploring the Internet
- Why geography is no longer an issue for writers
- How "instant communication" can help writers increase productivity and cut costs
- The new rules, and how they are changing the marketplace (both on-line and in print)
- The expanding marketplace, and how to explore it
- How to become part of an international community of writers
- What is expected of writers (and what to expect) in the electronic marketplace
- Myths associated with the Internet ("It will replace books and magazines!")
Chapter Two: Researching the Infinite Library
The key to effective research is understanding how the Internet "works" -- how to impose a logical search system upon an uncoordinated, uncataloged mass of data. This chapter will discuss search strategies specifically tailored to the needs of writers, including those seeking information for nonfiction articles and books, and those seeking background details for novels and short stories. Topics include:
Chapter Three: The Electronic Marketplace
- Selecting effective key words and search terms
- Locating and using "jump sites" (data centers that list key links in a topic area)
- Determining the value of a site (and learning how to prescreen search "matches")
- Knowing when to keep looking, and when to stop
- Using meta-search engines
- Using on-line bookstores, databases, forums, and other research sources
Today, the Internet has become the writer's marketplace. Magazines that have never been listed in Writer's Market host Web sites on-line, offering editorial guidelines and the equivalent of electronic "sample copies" (a real money-saver for writers). Electronic newsstands offer links to thousands of publications, and make international publications as accessible as domestic markets. High-quality, paying e-zines and e-mail newsletters are also emerging in a variety of fields. This chapter addresses:
Chapter Four: Protecting Your Rights
- How to use electronic newsstands to find domestic and international markets
- How to locate market information (including guideline databases and market newsletters)
- How to preview a magazine site before spending money on sample copies
- Exploring electronic markets
- Locating book publishers: Learning their needs, backlists, and guidelines
The downside of the emerging electronic marketplace is the threat to writers' reprint and electronic rights. Increasingly, print publications are attempting to lock in electronic rights or "all rights" against possible future electronic uses. This chapter (based on an extensive survey of e-zines and print magazines) will discuss current trends in the area of electronic rights, recent lawsuits on the issue, and ways writers can protect themselves.
Part II: Interacting on the Net
Chapter Five: The Basics of "Netiquette"
Is e-mail just another form of correspondence? For writers, the answer is "yes and no." Many writers fear that contacting editors by e-mail is too "informal"; many editors, on the other hand, prefer such correspondence. This chapter will discuss how e-mail can be used as an extension of the way writers currently do business, including:
Chapter Six: Writer's Groups and How to Use Them
- How to make "first contact" with new markets
- When and how to use e-queries, and how they differ from traditional queries
- What to do about "clips"
- How to format and submit a manuscript electronically
- How to use attachments (and when to avoid them)
- How to maintain professionalism in electronic correspondence
- How to locate and interview experts and professionals
- How to conduct on-line surveys
Writers' groups on-line are a lot like writers' groups in the "real" world. However, they also have certain advantages: You don't have to drive anywhere, you can participate on your own schedule, and the donuts aren't stale. An on-line discussion or critique group can help you stay motivated, address specific questions, and provide useful feedback on your work. This chapter reviews:
Chapter Seven: On-line Writing Courses
- How to locate and join a listserv mailing list or mailing group (including how to select options such as "digest" and "repro")
- What to expect from a group, and what the group will expect from you
- Netiquette basics, including a comparison of moderated and unmoderated lists
- How to choose a critique group and how to submit material
- How to write an effective critique (and assess those you receive)
- How to participate in a workshop or chat-group
- How to use lists to network with professionals and find research contacts
- How to use forums and bulletin boards
The Internet offers dozens of writing classes, some for free, some for a fee. Find out what such classes involve and how they work in this chapter, which covers:
Part III: Creating a Presence on the Web
- How to locate on-line classes that relate to your interest or specialty
- How on-line classes work: Lectures, discussions, and homework
- "Online Writing Laboratories" (OWLs) and other resources for writers
Chapter Eight: Do You Need a Web site?
Writers hunger to be heard, and one way to satisfy that hunger is to build a Web site. The wrong kind of site, however, can do more harm than good (posting unpublished works on a site, for example, virtually shouts "amateur"). First, a writer needs to determine a focus: Is the site intended to promote one's work and attract new readers? Is it designed to impress editors with expertise in a particular subject area? Or is it intended to help and guide other writers? This chapter discusses:
Chapter Nine: Promoting Your Book on the Internet
- Defining the goal of your site and determining its audience
- Content, content, content: The most important component of your site
- How to select, post, and exchange links
- How to promote your site and attract visitors
- How to monitor, maintain, and update your site
- How to handle site-generated correspondence
- Building forms and scripts into your site
If you're an author, you want readers. More to the point, you want people to buy your books. The good news is that the Internet offers a host of promotional opportunities that are absolutely free; the key is knowing how to exploit them effectively. This chapter will discuss how to attract readers and turn them into buyers (and even marketers) of your work:
Chapter Ten: Other On-Line Opportunities for Writers
- How to use your Web site to promote your books and attract readers/customers
- How to promote your book (and site) through links, networking, and other connections
- How to take full advantage of on-line bookstores (and how to profit from them)
- How to promote a self-published book
- How to network with other authors
- How to work with your publisher to promote your book
- Other book promotion tools (including e-mail signature blocks)
- Pros and cons of electronic "self-publishing"
In addition to expanding a writer's "traditional" markets and opportunities, the Internet offers new opportunities for writers to earn money from their skills. This chapter will discuss:
- How to start an e-zine or e-mail newsletter
- How to finance and promote a publication and develop a subscription base
- How to use autoresponders, majordomo software, and other response software
- How to develop and promote an on-line writing course
- How to become a paid "Web site guide"
- Other on-line opportunities
- o How to cite Internet sources in footnotes and bibliographies
- o Useful sites for writers (listed by category)
Medical History Textbook Proposal
Robin L. Anderson Ph.D.
Professor of History
Arkansas State University
I. Market Considerations
A. General Market
This textbook is designed as the primary general textbook for a History of Medicine course. This course is generally an elective upper level history course in 4-year institutions, and is a required course in most university medical schools.
There would be no prerequisites for such a course, although general surveys of U.S. history and world civilizations would be beneficial. Such courses are normally a part of a general education block of required courses.
B. Market Segment
This textbook would be used at the junior/senior level, and at the Masters or first year medical school level. It would also be attractive to the general reading public.
There are relatively few general histories of medicine textbooks available. A number of them do not reflect even moderately recent scholarship, as they were published before 1985. The only pre-1985 work which remains a classic study is William MacNeill's Plagues and Peoples, which is an outstanding study of the interactions of infectious diseases in the human populations, but it is not intended as a general medical history text.
There are only two textbooks of medical history written since 1990: Roy Porter's The Greatest Benefit to Mankind (1997), and Lois Magner's A History of Medicine (1992). Both cover the major topics quite adequately, and the Magner work is written in a reader-friendly style. The Porter book is a more traditional type of medical history textbook, paying a good deal of attention to the individuals whose discoveries forced progress of the profession. It does have the advantage of being available in both hardback and paperback editions. The Magner book spends more effort on the impact of disease and health on past societies and economies, and less on the "great men in history". However, it had three problems: for one it is only available in hardback, from a relatively small press, making it quite expensive, and not widely marketed. Secondly, although it has a few illustrations (noticeably more than the Porter book), it is predominately text, making it less attractive to the student, and the general reading public. Finally, it was published in 1992, never reprinted, nor revised. There has been a good deal of new scholarship in the past decade which needs to be incorporated into a medical history textbook.
II. The Book
A. Brief Description
Most medical history texts currently available adopt the "great men in medical history" approach. My textbook would address what I perceive as a lack of coverage in these texts: the impact of disease and health (or lack of health) on the history of world populations. While most people have heard of the Black Death, that is where most people's knowledge of the effects of disease on history ends. The general population, and students in particular, have little inkling of the many ways that health problems have impacted major events. For example, had Athens not been decimated by an unknown plague in 430 B.C., Sparta might well have not won the Peloponnesian War, and the post-classic story of Greece, and the development of the Roman Empire would have been very different. There are literally dozens of such examples throughout history.
This book would fall in the classification of social and economic history. Its focus would demonstrate not only the development of the health care professions and institutions, but more importantly the effects that health care problems and solutions have had on the common man and woman, and the society and economy in which they functioned. Attention would also be given to issues in medical care that have evolved, for example in the 20th century, a discussion of basic bioethics, and an examination of the development and dangers of bioterrorism. Because of the strong social history slant, the book will also address in some detail the role of women in health care, and the role of medicine in the history of children and the family.
The overall format will be chronological with certain threads or themes reappearing regularly. Thus, common topics such as herbal pharmacology, the naturalistic/supernaturalistic paradigm, and health-care delivery methods would appear in discussions of ancient Mesopotamia, Renaissance Europe, and 20th century America. To use another example, Chinese medicine will be discussed in some detail in the early material, but will also reappear when discussing the current relationship between Western medicine and "alternative medicine" in modern America. Material on 20th century bioethics would be preceded by discussions of Confucian medical ethics in ancient China and the Hippocratic ethics of classical Greece.
B. Outstanding Features
Most textbooks on medical history focus on the contributions of "great men" to the history and development of medicine. Simply discussing the individual contribution of the great medical leaders of the past, however, does not enable the reader to understand the ways in which life, death, illness, and injury were completely intertwined in human populations throughout world history. My textbook will be an effort to "put a face" on the problem of disease and trauma, not just as these issues have been addressed by individual "men of medicine", but as they affected the common man -- and the common woman. This textbook will put a strong focus on women's role in health care delivery. Women's entrance into the formal health care professions has been an historic struggle only resolved in relatively recent times. Consequently, for centuries the role of women was normally an informal one performed in the context of the family. It was nevertheless, a major force in assisting births, comforting the sick, and attending the dying. In its focus upon the common man, the book will also cover such topics as the position of children in society, and the role of the family.
This textbook will also demonstrate the tremendous impact of infectious disease at various critical points in history. It will show the pale horseman to have been a major player in such major events as the Hundred Years War, Napoleon's attempted conquest of Europe, and the Europeans' successful invasion of the New World, among others.
Another departure from the traditional medical history textbook will be my focus on the decidedly nonlinear progress of solutions to medical problems. Most textbooks show the science and art of medicine as constantly improving, a paradigm which overlooks the problems created by progress (and by historical events). A discussion of issues such as antibiotic-resistant bacteria, technological advances versus rising costs and scarce resources, and the changing definitions of death will counter the image of constant improvements in medicine.
Another aspect of the book will be the considerable emphasis on illustration. Academic survey texts on medical history do not usually have much in the way of visual components to demonstrate textual material. There are some very attractive "coffee table" books on the subject which do have a good deal of art and illustration, but these tend to be somewhat short on text and are generally very expensive. This textbook will fall in the middle ground, with sound scholarly written material and many illustrations as well.
The book will also make use of sidebars and vignettes, rather in the style of most world civilization textbooks. Quotations from contemporary writers and sidebars of support materials can be used to further illustrate the points being made in the text and enhance learning potential and retention rate of the material.
Finally, the chapter layout would use a combination of ordinary text and some of the aspects of world civilization survey textbooks. The chapters would have clearly labeled subdivisions, and bold-face type would be used to identify key terms. Definitions of such terms would then be found in a glossary at the end of the book. At the end of each chapter, there would be a short list of suggested readings and if appropriate, a list of high-quality Internet sources for further research. All these components are routine in most general history survey textbooks, but are not done in the history of medicine textbooks. They would all greatly enhance the appearance and readability of the book, making it attractive so that students will use the book profitably and easily.
i. Outline of typical chapter
ii. Supplemental material
- Introduction -- general overview of chapter and chapter themes
- Text with large margins
- Subheads to break chapter into components
- 10-12 illustrations, sidebars, or vignettes
- Use of bold face to accent key terms unfamiliar to reader
- Draw material themes together, lead into next chapter
- End material -- suggested readings, internet sites
This textbook can certainly be used as a stand-alone reader. With a thorough index and glossary, students should be able to locate desired material quickly, and a list for further readings will allow them to pursue topics they find interesting.
Having said that, however, this book could also be very profitably linked to a book of readings, a proposal for which is forthcoming very shortly. Such a supplement would have several selections of historical materials and current scholarship, keyed to each chapter in the textbook. There would be a wide variety of selections that instructors could pick and choose supplemental readings to enhance both lecture and reading materials. As the proposal for this book of readings will demonstrate, this additional volume will fill a very important lacuna in the field, as there is to my knowledge no such book of readings available at present.
Another possibility for future development would be an interactive component on CD-rom. It could contain research suggestions, auto-administered student tests, study guides, and a great deal more. Such a project would be a profitable add-on to the offering at some future date.
D. Table of Contents
Chapter 1: Health in Prehistory
- Introduction to idea of history of medicine
- Historiography of field of history of medicine
- Major themes and focus of this book
Life for prehistoric man was anything but a Garden of Eden. Indeed, Thomas Hobbs' description of a life that was "nasty, poor, brutish, and short" was generally an accurate picture of the existence of pre-literate man. As long as human societies have existed, diseases have stalked them and trauma has posed serious peril, and only with new forensic technology are researchers beginning to understand the diversity of those ills. With the domestication of plants and animals, and with the emergence of the early cities, the epidemiological picture of early societies did not improve measureably. Dependence on cereal crops and vulnerability to harvest failure actually impoverished the prehistoric diet, with accompanying decline in the general health of the population.
From the beginnings of human society, Man had to devise an explanation for the various ills and traumas that befell him. Early Man proved to be a remarkably good observor of his world, but a poor interpreter of what he saw. Thus, from the earliest times, medicine became closely aligned with religion, magic, and the supernatural. Disease and death, as well as cures, were attributed to actions of various gods and spirits in an effort to explain the unexplainable, a paradigm that has lasted into the 21st century.
Chapter 2: Ancient Middle East -- supernaturalism and medicine
- Explanation of the antiquity of trauma and disease
- Limitations of sources and advances in new technologies
- Dominance of supernaturalistic medicine
- Life cycle of pre-agricultural Man
- Medical importance of the development of agriculture
- Health and illness in early cities
- Conclusion and end materials
The art and practice of healing began to emerge as a profession among the major civilizations of the ancient Middle East. With increases and consolidation of population in Egypt, Sumer and Babylon, and in the Palestine, and with the creation of agricultural surpluses, a class system developed which included non-farmers. The priestly class not only attended to religious matters in Egypt and Mesopotamia, but also became healers to the new wealthy classes who could afford such services. Among the Hebrews in the Palestine, secular physicians practiced openly but were not held in high regard.
In the Mesopotamian civilizations of Sumer, Babylon, and Assyria, the supernatural explanation of disease reigned unchallenged, but in Egypt a new naturalistic theory of healing developed which existed alongside the supernaturalistic. With that exception, however, the healing arts of the ancient Middle East were overwhelmingly based on the supernatural definition of disease, whether by action of the Egyptian god Set or the Hebrews' Yahweh.
Chapter 3: India and Asia -- rise of the non-western medical traditions
- Babylon and Mesopotamia
- Hebraic medicine and Old Testament
- Conclusion and end materials
The western tradition of medicine was by no means the only one developing in the ancient world. In India and China, strong theories regarding the practice of medicine began to emerge by roughly 1500 BCE. Traditional Chinese medicine took a non-anatomical approach to disease and pain that has lasted to the present day. The Ayurvedic medical theories of ancient India also continue today, although influenced by both Islamic and western traditions as well.
In both India and China, ancient medical practices were based on the supernaturalistic paradigm for many centuries. However, in both cases, the naturalistic and holistic approach took hold, in the form of the Ayurvedic texts in India and in the Chinese concept of systematic correspondence. In both cultures, a number of sources have survived to give us a clear picture of the development of unique and coherent medical traditions largely divorced from western influences.
Chapter 4: Greece -- supernaturalism and the emerging naturalistic medicine
- Conclusion and end materials
By the time of the writing of Homer's Iliad, about 800 BCE, the western medical tradition had shifted its locus to the Aegean civilizations. Indeed, the Greeks produced the man known as the "Father of (western) Medicine", Hippocrates of Cos. The influence of Hippocrates and his followers would dominate medicine for centuries, and Hippocratic thought remains the ethical basis for modern medicine. Although Homeric medicine remained grounded in the supernaturalistic paradigm, the treatment of battle injuries was pushing medicine in an anatomically based direction. Both theoretical constructs existed simultaneously throughout the Hellenic world, as healing began to take a decidedly holistic approach. Although Hippocratic medicine contained serious errors by modern standards, it laid a permanent mark on western medicine.
In the post-classic era known as the Hellenistic World, Greek medical knowledge blended with that of Persia. A new interest in dissection added much new material in anatomy and physiology, and new schools of medical theory emerged. While it is relatively easy to trace the continued professionalization of medical practice, it is more difficult to see the impact of such change on health, disease, and trauma on the overall populations of the time. Famine and infectious disease continued to eliminate large numbers of people, and attempts at healing by the common man continued to have relatively little success.
Chapter 5: Rome and Byzantium
- Pre-Hellenic Aegean cultures
- Hellenic Greece and Hippocratic medicine
- Hellenistic World and Persia
- Conclusion and end materials
Medicine continued to become more of a profession during the centuries in which Rome dominated Europe and the Mediterranean Basin. A large number of diverse opinions regarding diagnosis and treatment existed throughout the Roman Empire, even though few physicians were formally educated. Rome provided a major contribution to the advancement of medicine and the overall health of urban populations with the development of such public health measures as improved water supply and sanitation. There were also important advancements in military medicine as the Roman legions were supplied with doctors and with some of Europe's first hospitals.
After the fall of the Roman Empire in Western Europe, the eastern, or Byzantine, Empire emerged as a leader in the preservation of medical knowledge. The era of Byzantium was by no means a healthy one, and overall medical care declined in the face of plagues, wars, and famines. In addition, healing was increasingly focused once again on the supernatural explanation of illness as Christianity rapidly gained popularity. Nevertheless, the Byzantine Empire was extremely important as the sole repository of medical writings as such knowledge began to disappear in Western Europe.
Chapter 6: Medieval Europe
- Roman life and society
- Roman armies and advances in military medicine
- Byzantine medicine
- Conclusion and end materials
As the Middle Ages progressed in Europe, the medical arts enjoyed only a few improvements. Indeed, as the pursuit of knowledge declined between roughly 500 and 1500 CE, the advances in naturalistic medicine made by men like Hippocrates were put aside in favor of the supernatural, now Christian, explanation for the various accidents and ills affecting the human body. Prayers, holy relics, and the intercession of saints were regarded as the proper cures for disease and trauma, and the Hippocratic Corpus was rejected in favor of the error-laden writings of Galen.
There were some important developments in the field of medicine during Europe's Middle Ages. The healing arts were clearly dividing between the professional physicians and the uneducated or poorly educated herbalists, midwives, and barber-surgeons. The rise of the university with its attached medical schools demonstrated the beginnings of professional education, but few men graduated in comparison to the need. Europe in the Middle Ages was a very unhealthy place, both from chronic problems such as nutritional deficiencies and reproductive difficulties, and from the regular appearance of famines, wars, and above all, infectious diseases. While it is difficult today to be sure about the exact identity of diseases sweeping across Europe, there is no doubt about the most famous epidemic of all time that struck in the mid-14th century -- the Black Death.
Chapter 7: Non-European Medicine 700-1500 CE
- Collapse of knowledge in Europe
- Interface of Christianity and medicine
- Women and medicine
- Rise of medieval university and medical schools
- Medieval epidemics and other health risks
- Black Death
- Conclusion and end materials
While Europe saw little advancement in science and medicine during the Middle Ages, other regions saw a great deal of activity. In particular, medicine in the Islamic world enjoyed considerable improvement. In addition to the great physicians of the Eastern and Western caliphates, Islamic medicine made its greatest contribution through the preservation of learning, with a concerted effort to collect all known writings. There were also a number of improvements in the fields of chemistry and pharmacology, with the introduction of new drugs from desert ecosystems and with new concepts such as the "palatable dose", the novel idea that medicine did not have to taste bad in order to be effective.
On the other side of the world, the great civilizations of the Americas were developing their own medical practices and pharmacoepia. Supernaturalism dominated the healing arts of the Maya, Aztecs, and Incas, but at the same time pharmacology, dentistry, and surgery were widely practiced, with some exceptionally good results. The Americas remained the healthiest continents in the world before 1500 because of the absence of the infectious diseases which destroyed whole populations in Europe, Africa, and Asia. Such an idyllic picture changed rapidly and drastically after 1492, however, as the virgin American populations were annihilated by Old World diseases.
Chapter 8: Early Modern Europe -- technical and theoretical change
- Islamic medicine and preservation and advancement of knowledge
- Health, disease and trauma in the Americas
- Developments in Asia
- Conclusion and end materials
The new intellectual currents of the Renaissance and later during the Scientific Revolution and Enlightenment revitalized medicine and surgery in Europe. Along with the revival of classical knowledge and a new interest in humanism came major discoveries in human anatomy. Surgical techniques, primarily related to battlefield injuries, improved somewhat, and new interests in chemistry advanced the field of pharmacology. In short, although medicine could not yet be considered truly "modern", ie based on the germ theory of contagion, a great deal of groundwork was laid in early modern Europe for subsequent improvements.
The pace of medical change increased rapidly during the Scientific Revolution, as scientists and doctors adopted the principles of the experimental method. It would take considerable time for results from their labs to make their way into common practice, but the process had begun. During the Enlightenment, as philosophers pondered such issues as the relevance of government and the nature of Man, medicine also reflected new intellectual trends. New interest and advances in mental health care and the importance of public health were slowly translated into changes in treatment of individuals and their overall environment. The modern era of medicine began to emerge.
Chapter 9: Early Modern Europe -- health, disease, and trauma, and society
- New developments in Renaissance- sea change in medical theory
- Academic medicine and new inventions
- Effects of Scientific Revolution and Enlightenment
- Conclusion and end materials
Even though the study of medicine and the sciences underwent major improvement in Europe before the Intellectual Revolution, the advances did little or nothing to improve the lives of ordinary people of the time. While some interest in public health appeared, little was done to improve living conditions. Most medical care was given by laypeople within the context of home and family, while frequent famines and outbreaks of infectious diseases continued to restrict population growth. The supernatural paradigm of causation and cure of disease remained dominant, while abnormal behavior continued to be regarded as caused by supernatural forces such as witches. New epidemic diseases such as typhus and scarlet fever appeared frequently, and nutritional problems of scurvy and rickets remained unsolved. The discovery of the Americas by Europeans initiated the worldwide spread of European diseases and the accompanying devastation of native populations.
The Scientific Revolution of the 17th century and the Enlightenment of the 18th century did begin to bring improvements in the overall picture for the common man and woman. New inventions such as the microscope and stethoscope and new theories such as Harvey's concept of the circulation of blood permitted advances in scientific discovery and in diagnosis. Major advances such as Jenner's discovery of the smallpox vaccination, while met initially with great skepticism and resistance, offered hope for escape from that scourge. Above all, the Enlightenment notion that the wealth of a nation was dependent on the health of its citizens provoked new improvements in public health measures, one field of medical science most quickly felt by the masses. In short, the early modern period in Europe saw many advances in medicine, beginning to improve the life of the common man and preparing the way for the explosion of medical knowledge in the 19th century.
Chapter 10: Nineteenth Century -- dramatic change for societies and for individuals
- Life and death for ordinary people
- Problem of witchcraft
- Conquest of the New World -- smallpox and syphilis
- Medicine in the Age of Revolutions -- France and Napoleon
- Enlightened despotism and beginnings of interest in public health
- Conclusion and end materials
The 19th century saw more advances in Western medicine in a few decades than in all previous history combined. The term "revolution" suggests radical, abrupt, and permanent change, and the era known as the Bacteriological Revolution provided exactly such change. Along with the new theories and practices of men like Pasteur and Koch came discoveries and advances in science which literally revolutionized medicine at all levels. Even though epidemics such as yellow fever and tuberculosis continued to ravage populations throughout the world, science began providing tools necessary for control of such infections. The coming of the Industrial Revolution meant rapid urban growth and massive problems of pollution and overcrowding. The sanitary movement which began to England led the public health campaigns that soon were being adopted throughout the Western Hemisphere.
At the same time that science and medicine were improving at a phenomenal rate, the availability of the new knowledge for ordinary people was often less than desireable. Problems of poverty, limited transportation, and lack of education usually meant that the sick were treated at home, self-medicated with a variety of nostrums, and were rarely seen by qualified doctors. An enormous number of proprietary, or "patent", medicines became available, and quackery abounded as opportunists and charlatans made their fortunes at the expense of the sick. New schools of medicine such as chiropractic, hydropathy, homeopathy, and osteopathy developed, competing with the allopathic physicians for the money of an increasingly sophisticated market. Yet, even as medicine was firmly on the road to modernization, for those who preferred the supernatural approach, the new ideologies of Christian Science and Seventh Day Adventism offered alternatives. Without doubt, the 19th century was a time of progress, but for the public, it was also a time of enormous confusion and competing theories.
Chapter 11: Nineteenth Century -- spread and development of European medicine
- Bacteriological Revolution -- Koch and Pasteur
- Science and the new war on infectious disease
- Industrial Revolution and rise of sanitary movement in England
- Most feared epidemics -- tuberculosis, cholera, yellow fever
- Popular medicine and self-medication -- quacks, frauds, proprietary medicines
- Reappearance of the supernaturalistic paradigm
- Conclusion and end materials
As European medical practices rapidly made the conquest of pain and disease easier than ever before, western medicine also made its way around the world. The new field of tropical medicine became inextricably tied to European imperialism in Asia and Africa, with decidedly mixed results. New techniques of antisepsis and anesthesia made never-before-conceivable surgical interventions possible, particularly important to the practice of medicine in the military. Frequent wars throughout the world forced doctors and governments alike to combat infectious disease as well, and brought about the first concerted efforts by women to enter the professional medical ranks as nurses and eventually even as physicians. The hospital became the tool for research and training of medical students and offered a better chance of survival for its patients than ever before.
The 19th century also saw the beginnings of medical specialization. No longer could medicine be simply divided into medicine and surgery, as physicians began to specialize in fields as disparate as obstetrics and psychiatry. The combination of surgical breakthroughs, understanding and control of disease vectors such as the mosquito, the permanent appearance of women into the field, and the development of expertise in a vast number of different branches of medicine, all meant that the healing arts had reached a sophistication far beyond anything previous.
Chapter 12: Twentieth Century -- professionalization and specialization of the new medicine
- Imperialism and tropical medicine
- Advances in military medicine -- US Civil War and others
- Development of nursing profession and professionalization of women
- Surgical breakthroughs
- Beginnings of specialization -- dentistry and psychiatry
- Conclusion and end materials
The speed of new developments in medicine and surgery in the 20th century increased exponentially, as new discoveries immediately laid the groundwork for further research. Until the last quarter of the century, medicine appeared on the road to a world where disease and trauma posed little threat to human populations. Developments such as the discovery of sulfa and antibiotics promised control of infection; new diagnostic tests and equipment such as the x-ray and the CAT scan enabled physicians to discover diseases in the early, and more curable, stages; new surgical techniques changed that field so miraculously that the transplantation of organs, once seen only as science fiction, became nearly routine. Medicine continued to specialize in many different directions, from pediatrics to neurology to oncology, and many more. Hospitals and research institutions proliferated and continued to push forward into new research, as education of doctors and of the public in the western world made prevention the key to the control of disease.
Chapter 13: Twentieth Century -- the new social and economic context of medicine
- World War I new challenges, new responses
- Proliferation of specialties -- pediatrics to geriatrics
- Surgical sophistication -- excision to restoration and replacement
- Development of diagnostic technology -- xrays to ultrasounds
- Revolution in pharmacology -- wonder drugs and government involvement
- Laboratory and clinic -- clinical and applied science
- Institutional advances -- hospitals, research facilities, non-profit organizations
- New interest in education and prevention
- Nazism and the birth of international medical ethics
- Modern medical education
- Conclusion and end materials
Even amidst the magnitude of 20th century medical advances, the microbes continued to wreak havoc. War became far more deadly than ever before, and World War I dramatically demonstrated the horrors of combat, a trend continuing throughout the century. Infectious disease proved to be a continued risk, as epidemics of influenza, polio, and AIDS took their toll. While the advances of the 20th century offered great hope for the conquest of disease, the century also encountered many new problems and issues which arose to challenge the healing arts and sciences.
In the 20th century, new health care professions emerged, as physicians could rely on physical therapists, paramedics, nurse midwives, and others, a trend often resisted as much as encouraged. Overall health care in the developed countries continued to improve, and life expectancy rose sharply. The practice of medicine had to be considered, as never before, within a much larger context of politics and economics, as the public began to see health as an inalienable right rather than an often-unattainable goal. As scientific discoveries made new drugs and new procedures available, they also drove the costs of medical care far beyond an individual's ability to pay, leading to the development of the health insurance industry and eventual limitations on availability of care. As scientific medicine became increasingly expensive and as health care became depersonalized, an increasing number of people began to look again at non-western medical traditions, bringing about a resurgence of interest in Chinese medicine, herbalism, homeopathy, and a score of other alternatives.
Chapter 14: Brave New Century -- Dilemmas in 21st Century Medicine
- New epidemics -- influenza, polio, AIDS
- Development of military medicine -- World War II, Korea, Vietnam, Gulf wars
- Increased life expectancy and importance of chronic disease
- New health care workers -- paramedics, nurse-midwives, physician assistants
- Medical consumerism -- marketing of medicine
- Economics and politics in medicine
- Medically disenfranchised -- eugenics and racism
- Health insurance, the HMO, Medicare/Medicaid
- Resurgence of interest in non-Western medicine
- Conclusion and end materials
As the world moves into a new century, medicine continues to evolve in new directions, facing problems both old and new. The heady enthusiasm of the 20th century is now tempered with a realistic look at new challenges created by modern life, and by modern medicine. The enormous costs of medical care have created two worlds -- one, the affluent west where consumers demand cures for every ailment, and the impoverished world of Africa, Asia, and Latin America, where pollution, poverty, and lack of education mean that the most basic needs are often left unmet. As the world population grows, the last bastions of empty lands are invaded, the rainforests where new diseases such Ebola and other emergent viruses lurk, and where biological cures for many diseases are imperiled by unbridled destruction of habitat. The microscopic world is adapting to the new drugs, creating multi-drug-resistant strains of organisms against which there are few cures.
In Europe and the United States, medicine faces new challenges as scarce resources and rising costs of care have divided the population between those who can afford medical care and those who cannot. The field of bioethics now tries to develop ethical responses to such problems in the context of a population which feels entitled to the best care available. As life expectancy continues to rise, new issues regarding the end of life and euthanasia are raised. At the same time that we are living longer, developments in reproductive medicine have raised new questions regarding the right to procreate and the feasibility and moral issues surrounding cloning. Finally, as more humans inhabit the planet every day, and as resources become even scarcer, modern technology has now also produced new ways to kill and maim. Warfare has adopted the terrifying use of biological and chemical agents that pose the greatest threat ever to the human race. The fields of medicine will continue to develop and improve in the face of the new challenges, only to face dilemmas not yet even conceived.
- Introduction -- advances come with new problems
- Third World poverty and disease
- Environment and disease -- rainforest destruction and emergent viruses
- Problem of antibiotic resistance
- Natural remedies, alternative medicine
- New ethics for new medicine -- issues in bioethics
- New concept of patient as consumer with rights
- Scarce resources and rising costs
- End-of-life issues and euthanasia
- Cloning and reproductive medicine
- Biowarfare and bioterrorism
- Conclusion and end materials
III Status of the Text
Schedule for Completion
At present I have moderately detailed outlines for most of the chapters with general topics selected and some more detailed work. Each chapter needs to be written in rough form which will indicate places where further research is needed. Finally, I will have to select individual illustrations, sidebars, and vignettes for each chapter.
A rough guess on timeline is about two to two and a half years for the single book, and an additional six months to produce the ancillary book of readings.
I estimate having 9 or 10 chapters, plus introduction, index (10 pgs. est.), glossary (10 pgs. est.), and bibliography (20 pgs. est). A rough estimate for the number of keyboarded pages is about 650 manuscript pages.
Illustrations are one of the key components for the book. The book will have roughly 100 illustrations, plus sidebars and vignettes. These visuals would include black/white photos, full color reproductions of art work, line drawings, and a few charts and graphs. Part of the appeal of this book is the emphasis on visuals to attract the general reading public, and to aid in student retention of the textual material.
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