The role of local knowledge in medical practice: a trans-historical perspective.

This article explores the role of participant-observation and ethnographic writing in the shaping of medical practice since Hippocrates. Drawing on a range of historical sources and genres that include the 17th- and 18th-century medical topographies and medical geographies, 19th-century medical ethnography and folklore, and their marginal persistence into the 20th century in the form of Mexican pasante reports, I argue that these writings should not be approached as part of the history of anthropology, but as specifically medical genres related to medical practice. The abandonment of these ethnographic practices by modern biomedicine is, I conclude, a consequence of two related developments: the hegemony of clinical epistemology and the depersonalization and depoliticization of physicians' commitment to their patients.