Social History of Medicine - recent issues

A Tale of Two Discourses: The Historiography of Ottoman-Muslim Medicine

Mossensohn, M. S. — 2008-03-31

Although the history of medicine in the Ottoman period has received considerable attention, especially from Turkish scholars, standard general works on the history of Muslim science and medicine after the Middle Ages rarely discuss Turkish and Ottoman medicine. Furthermore, the limited discussion usually does not go beyond referring to great medical discoveries in the Ottoman Empire, or alternatively its intellectual decline. The yardstick for the evaluation of Ottoman medicine seems to have been exposure to and acceptance of European medicine. Ottoman medicine was positioned between two simplistic poles, the dichotomy of ‘east’. In this article, I try to answer two interrelated questions. First, why is it that despite its erudition, Turkish scholarship of Ottoman medicine is hardly utilised by western scholars, even those specialising in Muslim medicine? Secondly, why is it that the two discourses, the Turkish and the western, share (or at least used to share) a non-dynamic image of Ottoman medicine? I claim that the frozen image that appears in the scholarship came about because of two different discourses—one Orientalist and Arabist, the other nationalist and Turkish—which joined together at this particular point for different reasons.

'The Excellent Example of the Working Class': Medical Welfare, Contributory Funding and the North Staffordshire Infirmary from 1815

Tomkins, A. — 2008-03-31

Contributory funding schemes for hospitals typically emerged in the late nineteenth century, but the North Staffordshire Infirmary was probably the first hospital to obtain workers' contributions (dubbed ‘establishment’ funds) on a mass scale. The early years of the hospital's finances were characterised by crisis and instability but the establishment income became central to both its survival and its identity. Nonetheless, this gave rise to an anomalous relationship between working-class patients, who obtained admission as a matter of right, and wealthier subscribers, who continued to regard them as objects of charity. This tension was maintained for 90 years before workers secured representation on the hospital governing body. It may explain why the funding model was not promoted more widely at the time and why the hospital's pioneering experiment has been neglected.

Carcinoma Uteri and 'Sexual Debauchery'--Morality, Cancer and Gender in the Nineteenth Century

Nolte, K. — 2008-03-31

Contemporary popular medical discourse on cervical cancer is characterised by the idea that ‘cervical cancer is rare in nuns and common in prostitutes’. It is thus clear that this serious disease is closely connected to a dichotomy in gender politics. This paper seeks to show the connection between cervical cancer, morality and gender since the early nineteenth century. In the earlier part of the period, German physicians regarded female sexual activity outside marriage, and sex not directed towards reproduction, as the cause of the disease. Accordingly, every woman who developed cervical cancer aroused suspicions of having engaged in ‘too much’ sex or having committed ‘self-pollution’. Within this context, Susan Sontag pointed to the specific historical and cultural implications of the metaphorical interpretations of cancer and the ways in which these might burden patients. Following Sontag's injunction to resist a metaphorical interpretation of illness, this article reconstructs and deconstructs a moralising view of cervical cancer and its victims. The paper focuses on the first decades of the nineteenth century, an era of fundamental change in gender history and the history of sexuality.

Ethnicity, Migration and the Lunatic Asylum in Early Twentieth-Century Auckland, New Zealand

McCarthy, A. — 2008-03-31

In recent years, scholars have utilised patient case-books to unearth the social experience of the lunatic asylum, particularly with reference to gendered dimensions and the role of the family. Where migration is considered, the focus is on whether or not mobility led to higher rates of committal. In other studies where place of birth is included as a category of analysis, no cross-referencing exists with other elements such as gender, marital status or religious affiliation. Instead, class and gender, rather than ethnicity, are the defining categories. This paper is a preliminary attempt to rectify this manifest neglect. It is based on information relating to 389 foreign-born migrants committed to the Auckland asylum between 1903 and 1910. The paper has two main objectives. First, it attempts to ascertain the key demographic features of the asylum's migrant population. What were their origins, gender and religion? How long had they been in New Zealand and what can we glean about their migration strategies and networks? Second, the analysis focuses on a number of issues pertaining to ethnicity. What do the case-books reveal about ties to place of origin, language and inter-ethnic relations? A broad conclusion addresses the complicated issue of analysing subjective versus objective perceptions and representations of migration and ethnicity, and establishes the benefit and significance of adopting a comparative approach to the study of migration and ethnic identities.

Workplace Accidents and Early Safety Policies in Spain, 1900-1932

Silvestre, J. — 2008-03-31

During the late nineteenth and early twentieth centuries, workplace accidents came to be perceived as a serious public health problem. Preventive safety policies were implemented in industrialising nations. The impact of these policies, however, has received little attention. This article shows that early safety policies in Spain failed and, as a result, workplace safety tended to deteriorate. It confirms that legal regulation of safety standards and factory inspection, the strategy that became predominant in Europe, had little effect on reducing accidents. The International Labour Organization proposed supplementing legislation with further strategies that were well established in the USA, namely the use of workers' compensation programmes as an economic incentive for employers to invest in safety, and cooperation between employers and labour through the so-called Safety First movement. This article, however, argues that these strategies were difficult to adopt in Spain.

Nutrition and Health. The International Context During the Inter-war Crisis

Barona, J. L. — 2008-03-31

Nutrition became a common element of culture, economy and health when the state emerged as a social regulator during the second half of the nineteenth century. A new international landscape was shaped during the inter-war period. Expert knowledge and the science of nutrition became essential as a consequence of the crisis caused by the First World War, international conflicts, and the 1929 stock market crash. The present paper analyses the historical circumstances that made nutrition into a relevant factor for public health policies contributing to its transformation into an experimental science. In this article, the role played by international agencies (the League of Nations, the International Labour Office and the International Institute of Agriculture) and expert committees are considered, as well as the emergence of new scientific and instrumental concepts derived from physiological research, such as optimum diet and dietary standards. Specific cases are considered: rural dietaries in Europe, studies on malnutrition and the critical situation of the population during the Spanish Civil War and on the eve of the Second World War.

Framing Mental Illness, 1923-1939: The Maudsley Hospital and its Patients

Jones, E., Rahman, S. — 2008-03-31

British psychiatric care during the inter-war period has often been characterised in bleak and even punitive terms: an asylum system that required certification for treatment, radical and often risky clinical interventions of no established benefit to patients and a lack of empathy or creativity among doctors. Although the Maudsley Hospital was designed to break the asylum mould, the received view is that a distinctive admissions policy targeted those with a good prognosis, excluding the unruly and chronic. Using random samples drawn from 1924, 1928, 1931, 1935 and 1937–8, this paper explores how changing hypotheses about mental illness influenced the selection and management of Maudsley patients. The largest single diagnosis for in-patients was depression, although 24 per cent had a psychotic disorder. Almost all in-patients resided in Greater London. Only 13 per cent were unskilled workers, 30 per cent being from the professional class. While the key to understanding mental illness was thought to lie in the young, the in-patient population was largely middle-aged. In its operation, the Maudsley did not adhere to the founders' strategic plan but, in the absence of effective treatments, focused on the provision of a changing and varied patient population for its growing army of trainees and researchers.

Marginalising the Body at Work? Employers' Occupational Health Strategies and Occupational Medicine in Scotland c. 1930-1974

Johnston, R., McIvor, A. — 2008-03-31

This article engages with two main themes recently utilised by historians of health and welfare: the impact of periphery on health; and the strengths and weakness of public and private approaches to health care. The specific focus of the article is the nature of occupational health and safety in the industrial conurbation of west central Scotland between 1930 and 1974. Using a range of primary source material, the article compares and contrasts the relative paucity of health cover provided by the region's private employers with the more comprehensive health services enjoyed by workers in state-run industries and local authorities. The article also illustrates that, although the west of Scotland was the most extensive industrial region in Scotland and contained the biggest concentration of industrial hazards—including those derived from asbestos dust—and notwithstanding Glasgow's reputation for its pioneering public health initiatives, medical expertise regarding occupational health was poorly developed here. Indeed, as far as Scotland was concerned, a situation evolved from the 1960s in which occupational health expertise became located in Dundee and Edinburgh.

'Silence has its own Stories': Elizabeth Kenny, Polio and the Culture of Medicine

Rogers, N. — 2008-03-31

This essay examines four topics in medical history, drawing examples both from recent historical works and also from the author's own research on medicine in the United States in the 1940s and 1950s. The topics are the visibility and management of symptoms in clinical practice, particularly pain in polio; the changes in deception and truth-telling in clinical diagnosis and prognosis, such as the silence chosen by both physicians and families around terminal illnesses like ovarian cancer; debates around the etiquette of publicity within the medical profession and the historical creation of a lay ‘public’ considered irrational and easily swayed; and the making of medical films as sources of scientific evidence. A focus on Sister Elizabeth Kenny, an Australian nurse based in Minneapolis in the 1940s and early 1950s, who developed controversial methods of treating patients paralysed by polio, is used to link these themes together around the boundaries of medical authority: the struggle to define who can make symptoms visible and significant, give or withhold the truth of a terminal diagnosis, set standards of professional respectability, and assess the authenticity of evidence presented as ‘scientific’.

Unhealthy Neglect? The Medicine and Medical Historiography of Early Modern Wales

Withey, A. — 2008-03-31

The medical historiography of Wales is dominated by two themes: industrialisation and medical folklore. For the early modern period, this academic concentration on folklore has served to posit an unbalanced rural caricature with an over-emphasis on magical healing. Welsh medicine was actually a diverse mix of traditional and orthodox beliefs under one general model of understanding, affected by various factors including religion and urban growth. The study of the medical history of early modern Wales may also have wider implications, such as the importance of regionalism, rural and urban variations and the spread of alternative medical ideas such as Helmontianism. The interdependence of town and countryside also serves to highlight the ways in which medical information could be disseminated. Wales was not a rural enclave, and was part of a wider medical network. Many sources exist which can be used to shed light on early modern Welsh medical culture and such work could contribute to a better understanding of wider medical milieux by exploring variations as well as similarities. Further, such research would address a wider need for more rural studies and lead to a better understanding of the role played by distinct regions such as Wales.

Notes on Contributors

2008-03-31

Eating Spring Rice: The Cultural Politics of AIDS in Southwest China

Hog, E. — 2008-03-31

When Bodies Remember: Experiences and Politics of AIDS in South Africa

Poku, N. K. — 2008-03-31

The Aids Pandemic in Latin America

Laveaga, G. S. — 2008-03-31

Fixing Men: Sex, Birth Control, and AIDS in Mexico

Bliss, K. E. — 2008-03-31

Medicine, Madness and Social History: Essays in Honour of Roy Porter

Stewart, J. — 2008-03-31

An Oral History of the Education of Visually Impaired People: Telling Stories for Inclusive Futures

Turner, A. — 2008-03-31

Sperm Counts: Overcome by Man's Most Precious Fluid

Davis, G. — 2008-03-31

The Khat Controversy: Stimulating the Debate on Drugs

Berridge, V. — 2008-03-31

Advertising Sin and Sickness: The Politics of Alcohol and Tobacco Marketing, 1950-1990

Elliot, R. — 2008-03-31

The Medicinal Use of Opium in Ninth-Century Baghdad

Matthee, R. — 2008-03-31

Visualizing Medieval Medicine and Natural History, 1200-1550

Horden, P. — 2008-03-31

Inventing the Indigenous: Local Knowledge and Natural History in Early Modern Europe

Browne, J. — 2008-03-31

Secrets of Women: Gender, Generation and the Origins of Human Dissection

Katritzky, M. A. — 2008-03-31

Advancing with the Army: Medicine, the Professions, and Social Mobility in the British Isles 1790-1850

Cookson, J. E. — 2008-03-31

Food and the City in Europe since 1800

Waddington, K. — 2008-03-31

Black November: The 1918 Influenza Pandemic in New Zealand

Hyslop, A. — 2008-03-31

State of Immunity. The Politics of Vaccination in Twentieth- Century America

Jones, G. — 2008-03-31

Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955-1975

Hochman, G. — 2008-03-31

Race and Medicine in Nineteenth and Early Twentieth-Century America

Ellis, M. — 2008-03-31

'Deadly Medicine. Creating the Master Race'. Exhibition at the United States Holocaust Memorial Museum, 2004 to October 2005

Weindling, P. — 2008-03-31

Notes on Book Reviewers

2008-03-31

New Online Manuscript Submission Service

2007-12-12

Twenty Years of Social History of Medicine

Dolan, B. — 2007-12-12

After Death/After-'Life': The Social History of Medicine in Post-Postmodernity

Cooter, R. — 2007-12-12

Well supported and institutionalised, the social history of medicine thrives. Its research agenda is infinitely expandable, and its humanist sentiments continue to touch emotional cords. Politically and intellectually, however, it is sterile. In a material and intellectual world that is radically different from the one in which it came into being, the social history of medicine has lost its capacity seriously to engage. This paper suggests that medico-centric historians not only have the expertise to re-engage with the contemporary bio-centric world, but that they have need to do so, and, moreover, every reason to take to the task enthusiastically. Crucial to moving on is understanding and seriously engaging with the moral-political and epistemological landscapes for medicine and its historiography, past and present.

The Social History of Medicine: Beyond the Local

Lowy, I. — 2007-12-12

Editors of Social History of Medicine (SHM) have been very successful in extending the geographic range covered by the journal. The impressive geographic diversity of studies published in SHM has not, however, led to a parallel presence of comparative historical investigations. This article is a plea for promoting a comparative social history of medicine. Diseases are trans-national phenomena; medicine and public health are often global endeavours; medical practice is influenced by international rules and regulations, and by global economic and political trends; medical researchers and medical practitioners travel, as do their ideas, and developments in one country may affect those in other countries. Moreover, trans-national comparisons may display unexpected differences and/or surprising similarities; questions initially studied in one context can acquire a different meaning when transposed to another situation; a juxtaposition of developments in several sites can provide information impossible to obtain in single-site studies. Moving in space and not only in time can open new questions on interactions between medicine and society, and deepen our understanding of already existing ones.

Medical and Demographic History: Inseparable?

Woods, R. — 2007-12-12

The case is made for forms of medical history that focus explicitly on sickness, health and life chances; ones that explore the effects of health interventions by examining their impact on mortality risks. Using a series of examples drawn from environmental health, midwifery and obstetric care, the paper illustrates various ways in which long-term trends in health and mortality may be read together. But it also demonstrates how fraught with problems of description and interpretation this process is likely to be. Finally, a plea is made for evidence-based medical history where ‘progress’, ‘outcomes’ and ‘results’ are given privileged positions.

Beyond East and West. From the History of Colonial Medicine to a Social History of Medicine(s) in South Asia

Ernst, W. — 2007-12-12

This article reflects on theories and methodologies that have characterised the field of the history of colonial medicine over the last couple of decades. It discusses the merits and flaws of hitherto predominant conceptual paradigms that concerned themselves mainly with issues of power, governmentality, the status of modernity and the ‘condition’ of the colonisers and the colonised. The recent shift in research focus from western or colonial medicine to the multiplicity of indigenous medicines is assessed as a potentially more nuanced, balanced and adequately theory-focused as well as evidence-driven approach. It is argued that the seemingly irreconcilable tension and at times unhelpful hostility between proponents of Fanonian and Foucaultian paradigms on the one hand and archival data-focused historians of medicine on the other needs to be overcome lest researchers continue to be caught up in either ideologically fraught and conceptually misleading east versus west bifurcations or narrowly framed local case studies. Rather than discerning the end of social history of medicine research on south Asia, the author suggests that there is much scope and indeed urgent need for a social history of medicines in south Asia that is guided by crisp theory and at the same time anchored in the richly textured fabric of a wide range of economic, political, cultural and socio-historical sources.

The Patient's View Meets the Clinical Gaze

Condrau, F. — 2007-12-12

Roy Porter's 1985 article on ‘The Patient's View’ is the starting point for a methodological and historical reflection on the patient in medical history. This article gains its inspiration from the fact that to the present day, the history of patients as an intellectual project has not found much reflection. Old categories, such as patient, knowledge and disease, all need to be revisited and rethought. It sketches out several arenas where this debate will have to take place and contrasts Porter's patient's view with David Armstrong's writings on the constructed patient. It goes on to discuss the project of social history of medicine to begin to place Porter in the context of the discipline and closes with some comments on the political context of patients' history in the 1980s which coincided with the start of governmental reforms in the NHS intended to strengthen the patient's role.

The Comparative Study of Maternal Mortality over Time: The Role of the Professionalisation of Childbirth

De Brouwere, V. — 2007-12-12

Midwifery in western countries emerged during the seventeenth century in France with the training of midwives under supervision of male obstetricians. A wave of new schools of midwifery reached all European countries in the eighteenth century to reduce maternal and infant mortality. During the nineteenth century most European countries adopted a strategy for the promotion of skilled attendance at delivery based on professional midwives who progressively replaced traditional midwives. However, the effectiveness of the strategy reflected by the coverage of deliveries by these midwives varied widely among European countries. This was partly due to a conflict of interest with medical doctors. The reduction in maternal mortality was parallel to the intensity of the coverage by professional midwives with a clear contrast between the USA—with a staggering maternal mortality around 600–800 per 100,000 live births—and Sweden, Denmark, Norway or the Netherlands with a ratio around 250–300 per 100,000 live births. The more recent history of maternal mortality reduction in Sri Lanka and Malaysia showed that technical and political conditions similar to what will be shown to have prevailed in Sweden also permitted the dramatic fall.

Origin Stories and the Norwegian Radesyge

Lie, A. K. — 2007-12-12

The Norwegian radesyge, a mysterious and crippling skin disease, was regarded as one of Norway's most serious health problems in the latter part of the eighteenth century and the first part of the nineteenth century. The epidemic has been regarded as the key catalyst for the development of a public health system in Norway, including the first hospitals with a therapeutic intention (the so-called radesyge hospitals). It is generally believed that radesyge had its origin in the coastal town of Egersund, Norway, in the beginning of the eighteenth century. This article investigates how such a theory of origin arose, explicates what it has meant to the historiography, and illuminates the host of other origin stories existing in the eighteenth century, now largely forgotten. The article also attempts to make certain observations that pertain to origin stories in general.

The Old Eugenics and the New Genetics Compared

Ekberg, M. — 2007-12-12

One of the greatest fears associated with the new genetics is the resurgence of eugenics, but too often this assumes the new genetics is eugenics without investigating the diverse definitions and interpretations of eugenics. The aim of this paper is to critically investigate the concept of eugenics in theory and in practice and to question whether the new genetics is a renewal, reform or return of eugenics. The discussion is oriented around six key arguments that illuminate the central points of convergence and divergence between the old eugenics and the new genetics. Ultimately, the paper concludes that despite significant procedural, legislative and administrative differences between the old eugenics and the new genetics, and despite significant spatial, temporal and cultural variations in interpretation and implementation, at the ideological level, there is essentially no difference. The old eugenics was genetics and the new genetics is eugenics.

Infectious Diseases and Epidemiologic Transition in Victorian Britain? Definitely

Mooney, G. — 2007-12-12

Flurin Condrau and Michael Worboys recently denied that infectious diseases were part of the common experience of life and death in Victorian Britain and that epidemiological transition in this period was a ‘chimera’. This response argues that their ‘demolition’ of these shibboleths is itself an apparition. A substantial body of literature on Victorian mortality demonstrates that Condrau and Worboys's call for analyses of causes of death disaggregated by place, age and sex is outdated. Disputing Condrau and Worboys's narrow definition of infection, evidence presented here indicates that infectious diseases probably represented about 40 per cent of all deaths in England and Wales in the 1850s. This proportion easily exceeded 50 per cent in towns and cities, places where the majority of the population lived. Attention is drawn to published works on health gap measures and health expectancies which show that the decline of infectious diseases made a substantial contribution to improved life chances over the Victorian era. This shift in mortality patterns is interpreted as an integral component of the epidemiological transition.

Notes on Contributors

2007-12-12

Burroughs Wellcome & Co.: Knowledge, Trust, Profit and the Transformation of the British Pharmaceutical Industry 1880 1940

Anderson, S. — 2007-12-12

From Physick to Pharmacology. Five Hundred Years of British Drug Retailing

Barton, P. — 2007-12-12

Pneumonia before Antibiotics: Therapeutic Evolution and Evaluation in Twentieth-Century America

Daemmrich, A. — 2007-12-12

Prescribing by Numbers: Drugs and the Definition of Disease

Slinn, J. — 2007-12-12

Penicillin: Triumph and Tragedy

Wainwright, M. — 2007-12-12

Miners' Lung: A History of Dust Diseases in British Coal Mining

McCulloch, J. — 2007-12-12

Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

Turda, M. — 2007-12-12

Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue

Schwartz, M. J. — 2007-12-12

Blood and Homeland: Eugenics and Racial Nationalism in Central and Southeast Europe, 1900 1940

Weikart, R. — 2007-12-12

Civilizing Argentina: Science, Medicine, and the Modern State

Parker, D. S. — 2007-12-12

Colonial Dis-Ease: US Navy Health Policies and the Chamorros of Guam, 1898 1941

Luker, V. — 2007-12-12

Bioethics and Organ Transplantation in a Muslim Society: A Study in Culture, Ethnography, and Religion

Rispler-Chaim, V. — 2007-12-12

Infant Mortality: A Continuing Social Problem

Wolf, J. H. — 2007-12-12

The Bioarchaeology of Children: Perspectives from Biological and Forensic Anthropology

Bartelink, E. J. — 2007-12-12

Community Care in Perspective: Care, Control, and Citizenship

Noll, S. — 2007-12-12

A Geographical History of Institutional Provision for the Insane from Medieval Times to the 1860s in England and Wales: The Space Reserved for Insanity

Prior, P. M. — 2007-12-12

Early Detection: Women, Cancer, and Awareness Campaigns in the Twentieth-Century United States

Toon, E. — 2007-12-12

Medicine and the Market: Equity v. Choice

Gorsky, M. — 2007-12-12

Rockefeller Foundation Funding and Medical Education in Toronto

Boychuk, T. — 2007-12-12

Doing Medicine Together: Germany and Russia between the Wars

McFarland-Icke, B. — 2007-12-12

The Nation's Doctor. The Role of the Chief Medical Officer 1855 1998

Nottingham, C. — 2007-12-12

The Practice of Reform in Health, Medicine, and Science, 1500 2000

Wallis, P. — 2007-12-12

Men, Women, and the Birthing of Modern Science

Walker, K. A. — 2007-12-12

Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age

Souza, G. B. — 2007-12-12

The Making of Addiction: The 'Use and Abuse' of Opium in Nineteenth-Century Britain

Mold, A. — 2007-12-12

When Illness Goes Public: Celebrity Patients and How We Look at Medicine

Gartner, J. — 2007-12-12

Leprosy in Medieval England

Miller, T. — 2007-12-12

Medicine and Magic in Elizabethan London

Maxwell-Stuart, P. G. — 2007-12-12

Medicine-by-Post: The Changing Voice of Illness in Eighteenth-Century British Consultation Letters and Literature

Manuel, D. E. — 2007-12-12

Notes on Book Reviewers

2007-12-12

New On-Line Manuscript Submission Service

2007-07-25

Active Euthanasia in Pre-Modern Society, 1500 1800: Learned Debates and Popular Practices

Stolberg, M. — 2007-07-25

Historians of medical ethics have found that active euthanasia, in the sense of intentionally hastening the death of terminally-ill patients, was considered unacceptable in the Christian West before the 1870s. This paper presents a range of early modern texts on the issue which reflect a learned awareness of practices designed to shorten the lives of dying patients which were widely accepted among the lay public. Depriving the dying abruptly of their head-rest or placing them flat on the cold floor may strike us as merely symbolic today, but early moderns associated such measures with very concrete and immediate effects. In this sense, the intentional hastening of death in agonising patients had an accepted place in pre-modern popular culture. These practices must, however, be put into their proper context. Death was perceived more as a transition to the after-life and contemporary notions of dying could make even outright suffocation appear as an act of compassion which merely helped the soul depart from the body at the divinely ordained hour of death. The paper concludes with a brief comparison of early modern arguments with those of today.

'I can do the child no good': Dr Sims and the Enslaved Infants of Montgomery, Alabama

Kenny, S. C. — 2007-07-25

This article examines the influence of slavery and race on medical education, practice and research in the American South. Drawing on the published autobiography, case-histories, and correspondence of American slave surgeon and ‘pioneer’ gynaecologist, James Marion Sims, the contribution highlights a lesser known episode from his early career, namely his surgical treatment of enslaved infants suffering from trismus nascentium (neonatal tetanus). Sims became a highly prestigious figure in his later medical career, but the foundations of his success relied on the use of slave bodies and enslaved patients. These were typically distinctive features of the life of an ambitious medical professional in the slave South, where the profession profited from the institution of slavery, and human experimentation and medical research were advanced specifically through the exploitation of the region's enslaved population.

Dispensers, Obeah and Quackery: Medical Rivalries in Post-Slavery British Guiana

De Barros, J. — 2007-07-25

This paper examines the ambiguous place of medical assistants—dispensers—in a post-slavery British Caribbean colony, British Guiana, from the end of slavery in the 1830s to the early twentieth century. Although the latter were crucial to the functioning of the colonial medical system, local physicians resented them, complaining about the economic threat they posed and at times condemning them as quacks. These attacks were part of a wider discussion about the composition of the medical profession and the role of medical auxiliaries in colonial society, and to an extent, they echoed debates conducted in other jurisdictions in this period. But in the British Caribbean, this discussion was significantly different. There, long-standing views about obeah—an Afro-Creole medico-religious practice—as a particularly dangerous and uncivilised type of quackery was part of the discursive context. That those participating in this debate included African-descended physicians whose arrival in the medical profession was recent and contested demonstrates the vexed and complex nature of professionalisation in a post-slavery society.

'Because of Poverty brought into Hospital: ... ' A Casenote-Based Analysis of the Changing Role of the Edinburgh Royal Maternity Hospital, 1850 1912

Nuttall, A. — 2007-07-25

Although the shift from a social to a medical function which occurred in nineteenth-century general hospitals has been explored, the occurrence of such a change in maternity hospitals has not been considered. Recent analyses of such institutions have examined particular aspects only, and thus give a somewhat static picture. This paper uses analysis of patient records (themselves an under-exploited resource) to explore the changing function of the Edinburgh Royal Maternity Hospital from a provider of shelter during childbirth to the destitute to a source of skilled medical care. It concludes that, although the Hospital had adopted the outward features of a medical institution by 1890, its casebooks suggest that its purpose only decisively changed in the early twentieth century, and thus can perhaps be more appropriately linked with national anxiety regarding the health of babies and their mothers.

The Uppingham Typhoid Outbreaks of 1875 1877: A Rural Case-Study in Public Health Reform

Richardson, N. — 2007-07-25

Uppingham, a small market town in the East Midlands, suffered repeated typhoid outbreaks in 1875–6, centred on its famous boarding school. A fierce battle developed between the school doctor and the local medical officer of health (MoH), with the Local Government Board (LGB) struggling to satisfy the various parties, many of which had a vested interest in controlling rate increases. Faced with ruin if nothing were done, the headmaster, Edward Thring, removed the school to the Welsh coast for an entire year. The town's shopkeepers, heavily dependent on the school, forced the Rural Sanitary Authority (RSA) to implement better drainage, while Thring and others set up a private company to supply water to the town. Writers such as Hamlin, Hennock and Wohl have already pointed to the formidable obstacles to public health reform facing authorities in urban areas. Uppingham's experience, unusually well documented for a small community, suggests that in rural areas these difficulties were equally great, and that local leaders were hopelessly ill-equipped for the task they faced.

Patients' Relatives and Psychiatric Doctors: Letter Writing in the York Retreat, 1875 1910

Wannell, L. — 2007-07-25

This article investigates the practice of letter writing from family and friends of patients to doctors at the York Retreat asylum at the end of the nineteenth and beginning of the twentieth century. During this time, letter writing was an important part of asylum practice and a collection of incoming and outgoing letters remain in the Retreat archive. Using mainly incoming correspondence, this article will show how families and friends remained significantly involved in asylum life and patient care. It will investigate the practice of family letter writing, asking questions such as who wrote to the Retreat, how often and why. It will also look at what types of relationships families and friends constructed with doctors, proposing that they regarded them in a variety of ways, ranging from seeing them as employees to treating them as confidants.

Local Responses to French Medical Imperialism in Late Nineteenth-Century Algeria

Gallois, W. — 2007-07-25

This article offers the first account of the lives of Algerian-born doctors working in the French colonial medical service between 1870 and 1900. Their stories reveal the manner in which the idea of medical imperialism had collapsed in Algeria, as a result of maladministration, racial policies, competition between civil and military authorities, budgetary constraints and the rise of the colons. The article also indicates the way in which medicine became a locus of opposition to French rule. It shows how the first decades of the Third Republic were critical in terms of a shift from the earlier idea of medicine serving as an emblem of the mission civilisatrice to the ideological potential of medicine being seen in much more nuanced terms by both French settlers and Algerian locals. It is argued that the notion of cultural resistance to imperialism through medicine emerges in the 1870s and 1880s, thereby prefiguring the work of Fanon and the Front de Libération Nationale's later analysis of the ‘sickness’ of colonial Algerian society.

Gendered Dis/ability: Perspectives from the Treatment of Psychiatric Casualties in Russia's Early Twentieth-Century Wars

Phillips, L. L. — 2007-07-25

The historiography on disability and gender in the West suggests an association between ‘masculine’ ability and ‘feminine’ disability. In contrast, Russia's early twentieth-century literature on the treatment of mentally-ill soldiers reveals a broader range of choices in ascriptions of gender and dis/ability. While conceptions of ‘masculine’ ability and ‘feminine’ disability existed in Russia, these two permutations of gender and dis/ability were neither strictly opposed in professional medical literature, nor were they the only available options. Physicians and patients most intimately associated with psychiatric casualties in Russia's wars also considered certain individuals to be masculine and disabled, as well as feminine and able. This article discusses and interprets these issues and concludes by exploring some of the possible political and cultural reasons why understandings of gender and disability proved more flexible in Russia than in the West.

Soldiers in Psychiatric Therapy: The Case of Northfield Military Hospital 1942 1946

Thalassis, N. — 2007-07-25

This article discusses the psychiatric therapeutics of Northfield military psychiatric hospital and suggests that treatment in Northfield was characterised by ideals of citizenship typical of the period and inextricably linked to the military. The two Northfield experiments, for which Northfield has become famous, glorified the group as a social unit and promoted adaptation to the needs and values of society as the route to mental health. In the context of the Second World War, such adaptation meant accepting the duties of a soldier. In the published writings regarding the first Northfield experiment, the psychiatrist Wilfred Bion emphasised his military role in returning patients to their units, a job which he thought was best conducted by men like himself who had experience of leading men into battle. Writing about the second experiment, Tom Main emphasised the importance of including military staff in every aspect of the hospital life from therapy to administration. Some Northfield psychiatrists were less content with this strongly military approach and this led to the conflict which ended the first experiment and continued to spark disagreements throughout the hospital's existence.

The Medicalisation of Male Menopause in America

Watkins, E. S. — 2007-07-25

The topic of male menopause occupied space on the medical radar screen from the late 1930s through the mid-1950s, then virtually disappeared for the next four decades, until the late 1990s. By contrast, articles on this subject appeared in American popular magazines and newspapers at a consistent, if low-level, rate throughout the same period. This essay describes how the male menopause became medicalised, not by the driving forces of academic researchers and influential clinicians, but instead by a model perpetuated by lay people and medical popularisers. A medicalised conceptualisation of the body and the life-cycle had become widespread by the second half of the twentieth century, as Americans grew accustomed to regarding their lives through the lens of medicine. People came to expect medicine to provide a cure for any ailment; in the wake of the development of the so-called wonder drugs, no affliction seemed beyond medical and pharmaceutical intervention. A medicalised model had also been effectively produced for understanding and treating the menopause in women; a parallel, if not identical, stage in the life-course of men seemed reasonable. This framework, rather than persuasive evidence from the research laboratory or clinic, helped to medicalise male menopause and provided the basis for its eventual pharmaceuticalisation at the end of the twentieth century.

Notes on Contributors

2007-07-25

Food in Medieval England: Diet and Nutrition

Hieatt, C. B. — 2007-07-25

Medical Charlatanism in Early Modern Italy

Siraisi, N. G. — 2007-07-25

Hermaphrodites in Renaissance Europe, Women and Gender in the Early Modern World

Soergel, P. M. — 2007-07-25

The Mystic Mind: The Psychology of Medieval Mystics and Ascetics

Sweet, V. — 2007-07-25

Windows of the Soul: The Art of Physiognomy in European Culture 1470 1780

Ziegler, J. — 2007-07-25

The African Aids Epidemic: A History

Osseo-Asare, A. D. — 2007-07-25

The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease

Scully, J. L. — 2007-07-25

Profits Before People? Ethical Standards and the Marketing of Prescription Drugs

Anderson, S. — 2007-07-25

How Everyday Products Make People Sick: Toxins at Home and in the Workplace

Johnston, R. — 2007-07-25

Solving the Health Care Problem: How Other Nations Succeeded and Why the United States Has Not

Engel, J. — 2007-07-25

Financing Medicine: The British Experience since 1750

Dupree, M. — 2007-07-25

Rockefeller Money, the Laboratory and Medicine in Edinburgh, 1919 1930: New Science in an Old Country

Lowy, I. — 2007-07-25

Britain and the 1918 19 Influenza Pandemic: A Dark Epilogue

Bryder, L. — 2007-07-25