When Anna White Dildane, a prostitute and heroin addict, was committed to the Laboratory of Social Hygiene (LSH) in 1917, she was treated by a staff that anticipated the methods of the biopsychosocial model later developed by Engel. That is to say, the staff members believed that Anna's rehabilitation was contingent on a scientific diagnosis of the physical, mental, and social factors that underlay her condition. However, using Anna and the LSH as a case study, we draw from Latour to show the limitations of this modern method of diagnosis and treatment that persists today. Using Burke, we advocate for a pragmatic orientation focused on creating rhetorically oriented narratives whose aim is to help patients make judgments about their health and future, namely, by bringing about the experience of form capable of constituting new types of identification. Effective medical rhetoric thus adopts a method of persuasion that begins with the narrative and self-understanding of the patient, links aspects of that narrative with the technical expertise of physicians and other health care providers, and crafts a new, more specialized narrative attentive to the desires and constraints of a patient's form of identification that is ultimately the seat of judgment.
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机译：当妓女和海洛因依赖者安娜·怀特·迪尔丹（Anna White Dildane）在1917年被送往社会卫生实验室（LSH）时，她受到了一名工作人员的治疗，该工作人员预期了后来由恩格尔（Engel）开发的生物心理社会模型的方法。也就是说，工作人员认为，安娜的康复取决于对构成其状况的生理，心理和社会因素的科学诊断。但是，以Anna和LSH为例，我们从拉图尔（Latour）得出的结论表明，这种现代诊断和治疗方法的局限性一直存在至今。我们主张使用伯克（Burke）务实的取向，着重于创建以修辞学为导向的叙事，其目的是帮助患者做出有关其健康和未来的判断，即通过带来能够构成新型识别形式的形式的经验。因此，有效的医学措辞采用的是一种说服性的方法，这种说服方法始于患者的叙事和自我理解，将叙事的各个方面与医师和其他医疗保健提供者的技术专长相结合，并针对该主题制定了一种新的，更专业的叙事方法。病人的身份识别形式的愿望和约束，而这最终是判断的依据。
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