Journal of the History of Medicine and Allied Sciences - Advance Access

The Rise and Fall of Celiac Disease in the United States

Abel, E. K. — 2009-06-24

Because celiac disease is greatly under-diagnosed in the United States, a common assumption is that U.S. doctors and researchers always have considered the condition extremely rare. However, the disorder captured widespread medical attention at the beginning of the twentieth century. Luther Emmett Holt, a leading pediatrician, encouraged three other doctors to investigate the condition. Two helped to associate celiac disease with elite medical institutions. The third linked it to the marketing efforts of the United Fruit Company. Interest in celiac declined after 1965, partly as a result of the decreased concern with nutrition and nutritional disorders.

Mania: A Short History of Bipolar Disorder

Grob, G. N. — 2009-06-23

"A Dictate of Both Interest and Mercy"? Slave Hospitals in the Antebellum South

Kenny, S. C. — 2009-06-23

As a contribution to debates on slave health and welfare, this article investigates the variety, functions, and overall significance of infirmaries for the enslaved in the antebellum South. Newspapers, case histories, and surviving institutional records of antebellum Southern infirmaries providing medical treatment for slaves offer a unique opportunity to examine the development of modern American medicine within the "peculiar institution," and to explore a complex site of interactions between the enslaved, physicians, and slave owners. The world of the medical college hospital in South Carolina and an experimenting clinic in Alabama are reconstructed using newspapers and medical case histories. The Patient Register of the Hotel Dieu (1859–64) and the Admission Book of Touro Infirmary (1855–60) are used to highlight the types of enslaved patients sent to these two New Orleans commercial hospitals and to explore connections between the practice of medicine and the business of slave trading in the city. In addition to providing physicians with a steady income, slave infirmaries were key players in the domestic slave trade, as well as mechanisms for professionalization and the mobilization of medical ideas in the American South.

Enemies or Allies? The Organ Transplant Medical Community, the Federal Government, and the Public in the United States, 1967-2000

Festle, M. J. — 2009-06-20

The transplant medical community in the United States has frequently been divided over the appropriate role of the federal government and of the public in matters related to organ transplantation. Using public statements in government hearings, newspapers, and press releases, this article traces the thinking of the transplant medical community in particular during three especially politicized periods: the heart transplant and brain death controversies in the late 1960s, consideration of the National Organ Transplant Act and other legislation during the mid-1980s, and the controversy over organ allocation regulations issued by the Department of Health and Human Services in the late 1990s. Even while sometimes denouncing "politicization," over time surgeons, physicians, representatives of the United Network for Organ Sharing, and other leaders in the field became increasingly politically active and more accustomed to the notion that because of the unique nature of organ transplantation, both the public and the federal government have a legitimate and potentially beneficial oversight role.

Reforming Medical Education: The University of Illinois College of Medicine, 1880-1920

Haller, J. S. — 2009-06-17

What Was Tropical about Tropical Neurasthenia? The Utility of the Diagnosis in the Management of British East Africa

Crozier, A. — 2009-06-16

During the first quarter of the twentieth century, tropical neurasthenia was a popular diagnosis for a nervous condition experienced by Europeans in the topics. Tropical neurasthenia was not psychosis or madness, but was rather an ennui or loss of "edge" brought about by the strains of tropical life, especially the unfamiliar, hot climate. A catch-all for a wide range of symptoms, many missionaries, colonial staff, and settlers throughout Empire were repatriated because of it, although this article concentrates on Colonial Service employees working in British East Africa. While histories of tropical neurasthenia have usefully (and correctly) explained this diagnosis as an expression of the anxieties of the colonial regime, this article adds a new dimension to the historiography by arguing that tropical neurasthenia can only be properly understood as a hybrid form, dependent not only upon the peculiarities of the colonial situation, but also descended from British and American clinical understandings of neurasthenia. Moreover, once tropical neurasthenia is properly acknowledged as being typical of clinical understandings of the time, other reasons for its comparatively long endurance in the colonial situation emerge. This article shows that tropical neurasthenia remained a popular diagnosis in East Africa not only because (as historians have argued previously) it dovetailed with prevalent ideas of colonial acclimatization, but also because it was a practically useful tool in the management and regulation of colonial personnel.

Asklepios, Medicine, and the Politics of Healing in Fifth-Century Greece: Between Craft and Cult

Kapparis, K. — 2009-06-16

The Leprosy Asylum in India: 1886-1947

Robertson, J. — 2009-06-16

Writing against a historical practice that situates the leprosy asylum exclusively within prison-like institutions, this article seeks to show the variation in leprosy asylums, the contingencies of their evolution, and the complexity of their designs, by devoting attention to the characteristics of the leprosy asylum in India from 1886 to 1947, in particular to the model agricultural colony. Drawing upon the travel narratives of Wellesley Bailey, the founder of the Mission to Lepers in India, for three separate periods in 1886, 1890–91, and 1895–96, it argues that leprosy asylums were formed in response to a complex conjunction of impulses: missionary, medical, and political. At the center of these endeavors was the provision of shelter for persons with leprosy that accorded with principles of good stewardship and took the form of judicious use of donations provided by benefactors. As the Mission to Lepers began to bring about improvements and restructuring to asylums, pleasant surroundings, shady trees, sound accommodation, and good ventilation became desirable conditions that would confer physical and psychological benefits on those living there. At the same time, the architecture of the asylum responded to economic imperatives, in addition to religious and medical aspirations, and asylums moved towards the regeneration of a labor force. Leprosy-affected people were increasingly employed in occupations that contributed to their sustenance and self-sufficiency, symbolically reincorporating the body damaged by leprosy into the economic world of productive relations.

The Fog of Research: Influenza Vaccine Trials during the 1918-19 Pandemic

Eyler, J. M. — 2009-06-12

Bacterial vaccines of various sorts were widely used for both preventive and therapeutic purposes during the great influenza pandemic of 1918–19. Some were derived exclusively from the Pfeiffer's bacillus, the presumed cause of influenza, while others contained one or more other organisms found in the lungs of victims. Although initially most reports of the use of these vaccines claimed that they prevented influenza or pneumonia, the results were inconsistent and sometimes contradictory. During the course of the debates over the efficacy of these vaccines, it became clear that the medical profession had no consensus on what constituted a proper vaccine trial. Even among those who asserted that clinical impression was not enough, there was no agreement on how a trial ought to be conducted. The American Public Health Association, through its Working Program on Influenza, sought to establish standards for the profession. The standards the APHA set in December 1918 guided American vaccine trials for a quarter century.

"Who's Winning the Human Race?" Cold War as Pharmaceutical Political Strategy

Tobbell, D. A. — 2009-06-03

Between 1959 and 1962, Senator Estes Kefauver led a congressional investigation into the pricing practices of U.S. drug firms. As part of its defense, the industry mobilized the rhetoric of cold war and promoted the industry as a critical national asset in the global war against communism. The industry argued that any effort to undermine corporate innovation by inviting, as Kefauver proposed, greater government involvement in drug development threatened the public's health and invited socialism—in the form of socialized medicine—into the domestic political economy. This strategy proved critical to the industry's efforts to build political support for itself, particularly among the medical profession, and undermine Kefauver's reform agenda.