Journal of the History of Medicine and Allied Sciences - recent issues

How the Ideology of Low Fat Conquered America

La Berge, A. F. — 2008-05-07

This article examines how faith in science led physicians and patients to embrace the low-fat diet for heart disease prevention and weight loss. Scientific studies dating from the late 1940s showed a correlation between high-fat diets and high-cholesterol levels, suggesting that a low-fat diet might prevent heart disease in high-risk patients. By the 1960s, the low-fat diet began to be touted not just for high-risk heart patients, but as good for the whole nation. After 1980, the low-fat approach became an overarching ideology, promoted by physicians, the federal government, the food industry, and the popular health media. Many Americans subscribed to the ideology of low fat, even though there was no clear evidence that it prevented heart disease or promoted weight loss. Ironically, in the same decades that the low-fat approach assumed ideological status, Americans in the aggregate were getting fatter, leading to what many called an obesity epidemic. Nevertheless, the low-fat ideology had such a hold on Americans that skeptics were dismissed. Only recently has evidence of a paradigm shift begun to surface, first with the challenge of the low-carbohydrate diet and then, with a more moderate approach, reflecting recent scientific knowledge about fats.

Lies, Damn Lies, and Manchester's Recruiting Statistics: Degeneration as an "Urban Legend" in Victorian and Edwardian Britain

Heggie, V. — 2008-05-07

Few historians have attempted to discuss British medicine, health and welfare policies, or the biological sciences around 1900 without due reference to the concept of degeneration. Most tie public concern with degeneration to a specific set of military recruiting figures, which stated that of 11,000 would-be volunteers in Manchester, 8,000 had to be turned away due to physical defects. Further, most histories point out that these figures had a direct influence on the formation of the Inter-Departmental Committee on Physical Deterioration in 1904. With its absolute denial of hereditary decline, the 1904 Report acts as a dénouement of degenerationist fears in Britain. No historian has sought to contextualize these recruiting figures: Where did they come from? How did Manchester react? What role did that city play in the subsequent 1904 Report? Far from being the epitome of urban decay, the 1904 Report repeatedly hails Manchester as a glowing example of innovative urban reform. This article contextualizes the recruiting figures and explores how Manchester had been tackling the three key problems of Physical Deterioration—diet, exercise, and alcohol—for thirty years prior to the 1904 Report. By discussing Manchester, a new understanding of degeneration is outlined; as slogan, rhetorical tool, and urban legend, degeneration was largely feminized and domesticated. Military/masculine problems such as the recruiting figures were the exception, not the rule.

Rationalizing Medicine and the Social Ambitions of Physicians in Classical Greece

Chang, H.-H. — 2008-05-07

Political and social circumstances in the late Classical period increased upward social mobility in Greece and provided some doctors with an opportunity to improve their social status. By adopting rational medical theories and prescribing an upper-class oriented regimen, these doctors appealed to the elites who favored the teachings of natural philosophers and sophists at that time. These doctors' goal was to be accepted into circles of the social elite as intellectual companions. Their ambitions contributed to the fact that rational medicine in the Classical period did not become an empirical science. Instead, speculative theories were selectively used to explain the causes of health and disease and to guide these doctors' practices, because natural philosophical speculation was considered a "superior" form of knowledge by the Greek elites. Eryximachus provided an illustrative example of this strategy by attaining acceptance into the highest social circle of a Classical Greek city.

Primitive Madness: Re-Writing the History of Mental Illness and Race

Fearnley, A. M. — 2008-05-07

Andreas Libavius and the Transformation of Alchemy: Separating Chemical Cultures with Polemical Fire

Debus, A. G. — 2008-05-07

Chymists and Chymistry, Studies in the History of Alchemy and Early Chemistry

Jensen, W. B. — 2008-05-07

Midwifery, Obstetrics and the Rise of Gynaecology: The Uses of a Sixteenth-Century Compendium

Furdell, E. L. — 2008-05-07

Eighteenth Century British Midwifery

Wall, L. L. — 2008-05-07

The English Physician

Callery, B. G. — 2008-05-07

The Measure of Merit: Talents, Intelligence, and Inequality in the French and American Republics

Ponce, R. N. — 2008-05-07

The Secret Leprosy of Modern Days: Narcotic Addiction and Cultural Crisis in the United States, 1870-1920

Gabriel, J. M. — 2008-05-07

Poison, Detection, and the Victorian Imagination

Parascandola, J. — 2008-05-07

Streptomyces in Nature and Medicine: The Antibiotic Makers

Worthen, D. B. — 2008-05-07

The Controversial Story of Medicine's Greatest Lifesaver

Erlen, J. — 2008-05-07

The Vaccinators: Smallpox, Medical Knowledge, and the 'Opening' of Japan

Van Sant, J. E. — 2008-05-07

Our Shared Legacy: Nursing Education at Johns Hopkins Hospital 1889-2006

Keeling, A. W. — 2008-05-07

Goals of Medicine in the Course of History and Today: A Study in the History and Philosophy of Medicine

Grob, G. N. — 2008-05-07

Books Received

2008-05-07

RECENT DISSERTATIONS IN THE HISTORY OF MEDICINE

2008-05-07

The Role of the Physician: Eugene Sanger and a Standard of Care at the Elmira Prison Camp

Waggoner, J. — 2008-02-04

The conduct of American military physicians in prisoner of war (POW) camps has been called into question by the abuse scandals at Abu Ghraib and Guantánamo Bay. This essay explores the experiences of the first U.S. military physicians to confront POW patients in large numbers—events that occurred during the American Civil War. While POWs received sub-standard care in camps north and south, the war also saw the issuance of the first document to outline the rights of POWs. This ambivalence toward the proper care and treatment of the POW is evident in the career of Dr. Eugene Sanger, the first Union surgeon at the prison camp in Elmira, New York. Sanger demonstrated both concern about the sanitary condition of the camp and pride in the deaths of POWs as furthering the overall war aims. His cruelty attracted some censure, but Sanger never faced disciplinary action. He was honorably discharged and went on to become the Surgeon General of his home state. This article places his actions at Elmira in the context of medical ethics, Army orders, and Northern opinion in 1864, and it will argue that the lack of Federal response to Eugene Sanger's poor record while serving at the prison set a precedent for inferior medical care of POWs by American military physicians.

In-Migration and Diphtheria Mortality among Children in the Sundsvall Region during the Epidemics of the 1880s

Curtis, S. — 2008-02-04

While many works have examined urban mortality rates in nineteenth-century Europe, much less attention has been placed on disease patterns in the peripheral areas surrounding these population centers. This study demonstrates that during the Swedish diphtheria epidemic of the early 1880s, mortality rates among children living in the industrial parishes on the outskirts of the town of Sundsvall exceeded those found in the town itself. The epidemic was fueled by the mass in-migration of laborers and their families from distant provinces who sought work in the region's sawmills. Thus, in contrast to the common pattern of disease entering through a port city and spreading into the interior, in this case diphtheria followed the paths of migrants through the rural parishes of the Sundsvall region to the sawmills and then finally into the town itself. This spatial pattern was reversed in the late fall when migrants returned home. Conflicts within the medical profession regarding how best to prevent or contain diphtheria, popular suspicion and distrust of local physicians, and the introduction of the disease into a population with no prior contact with it, all helped increase the number of young corpses.

Nineteenth-Century British Psychiatric Writing about Homosexuality before Havelock Ellis: The Missing Story

Crozier, I. — 2008-02-04

Recent accounts of the emergence of sexology have addressed the role played by homosexuals and sexual radicals in framing the questions posed by psychiatrists. This work has focused largely upon American and Continental psychiatry (with regard to homosexuality), with attention to British sexologists sometimes being tied to contemporary feminist concerns with the sexual double standard. In both cases, psychiatrists are shown to be following other social movements. In the existing work, British psychiatrists of the nineteenth century who wrote about homosexuality have been largely ignored because it appears to have been assumed that very little material existed prior to Havelock Ellis' Sexual Inversion (1897). In this article, I demonstrate that there were a number of British psychiatric discussions of sexual perversions, and that these discourses show an engagement on the part of British psychiatrists with the theoretical issues that occupied their (mostly) Teutonic colleagues, rather than evidence of any other external driving force behind the production of sexological discourses. These sexological texts are either original papers, or reviews of Continental sources, both of which illustrate the importation of sexological ideas into Britain before the writing of Havelock Ellis.

Inclusion and Exclusion: The Politics of History, Difference, and Medical Research

Reverby, S. M. — 2008-02-04

Medical Charlatanism in Early Modern Italy

McClure, G. W. — 2008-02-04

The Great Stink of Paris and the Nineteenth-Century Struggle against Filth and Germs

Williams, E. A. — 2008-02-04

The First Miracle Drugs: How the Sulfa Drugs Transformed Medicine

Haller, J. S. — 2008-02-04

The Renaissance Hospital: Healing the Body and Healing the Soul

Sawday, J. — 2008-02-04

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

Crenner, C. — 2008-02-04

Perfect Motherhood: Science and Childrearing in America

Willett, J. — 2008-02-04

Charles Nicolle, Pasteur's Imperial Missionary: Typhus and Tunisia

Amster, E. — 2008-02-04

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

Luchi, M. — 2008-02-04

Doing Medicine Together: Germany and Russia between the Wars

Cocks, G. — 2008-02-04

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

Guerrini, A. — 2008-02-04

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

Stern, A. M. — 2008-02-04

Books Received

2008-02-04

RECENT DISSERTATIONS IN THE HISTORY OF MEDICINE

2008-02-04

The Rise and Decline of Tonsillectomy in Twentieth-Century America

Grob, G. N. — 2007-09-05

This article explores the rise and decline of tonsillectomy/adenoidectomy (T&A) in twentieth-century America. Between 1915 and the 1960s, T&A was the most frequently performed surgical procedure in the United States. Its rise was dependent on novel medical concepts, paradigms, and institutions that were in the process of reshaping the structure and practice of medicine. The driving force was the focal theory of infection, which assumed that circumscribed and confined infections could lead to systemic disease in any part of the body. The tonsils in particular were singled out as "portals of infection," and therefore their removal became a legitimate therapy. Nevertheless, what kinds of evidence could prove that tonsils were portals of infection? How could the effectiveness of tonsillectomy be determined? An inherent difficulty was the absence of any consensus on the criteria that would be employed to judge its efficacy. Yet tonsillectomy persisted despite ambiguous supportive evidence. Although criticisms of the procedure were common by the 1930s, its decline did not begin until well after 1945 and involved debates over the nature of evidence, the significance of clinical experience in the validation of a particular therapy, and the role of competing medical specialties.

Access Anxiety: HIPAA and Historical Research

Lawrence, S. C. — 2007-09-05

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) establishes new standards for the protection of private health information in the United States. The Privacy Rule, one of the specific regulatory provisions of the act, went into effect 14 April 2003 for covered health care providers, institutions, and businesses. The Privacy Rule directly affected medical archivists and their collections. It has significant implications for historians of health care, as well. The Privacy Rule is the first major regulation that protects the privacy of the deceased in perpetuity. It establishes requirements that researchers must satisfy in order to gain access to "individually identifiable health information" held by HIPAA-protected institutions. While these requirements will burden historians in some cases, the Privacy Rule could open up opportunities for well-prepared historians to work with a more extensive range of twentieth-century documents.

The Military, Psychiatry, and "Unfit" Soldiers, 1939 1942

Wake, N. — 2007-09-05

This article examines the psychiatric screening of U.S. soldiers during the Second World War, established by psychiatrist Harry Stack Sullivan (1892–1949), as a key moment in the public application of clinical psychiatry, as well as a turning point in Sullivan's intellectual and professional career. After a brief look at the ideas and expectations Sullivan brought to the screening system, I discuss a major problem of the screening: the mismatch between the medical concept of disease prevention and the realities of the mass screening as a public policy. As a way to highlight this mismatch, I focus on Sullivan's failure to protect homosexual men from medical and social stigmatization by screening them out of the armed forces. Despite his liberal approach to the issue of homosexuality before the war, which he had created in his clinical practice, Sullivan was unable to persuade the military and the public of gay men's right to serve the nation. The examination of how his sympathetic view of homosexuality became circumscribed reveals not only the gap between clinical insights and public policy, but also how tentative views of homosexuality in public debate among liberal psychiatrists during the decade preceding the war contributed to the failure to make non-homophobic policy in the 1940s. This article shows that the relative conservatism in the politics of sexuality among liberal psychiatrists, as well as the intransigent conservatism as seen in homophobic tradition of the Army, contributed to the discriminatory screening criteria.

Claude Bernard and An Introduction to the Study of Experimental Medicine: "Physical Vitalism," Dialectic, and Epistemology

Normandin, S. — 2007-09-05

This article explores the profound impact of the thought of Claude Bernard (1813–78) and his philosophy of experimentalism elaborated in his masterwork An Introduction to the Study of Experimental Medicine. I argue that Bernard's far-ranging theoretical impact on medicine and biology marks the end of conventional vitalism and the elusive notion of a "vital force" as a legitimate scientific concept. His understanding of medicine is as epistemologically significant in its time as Newton's contribution was to the physical sciences in the seventeenth century. This essay treats Bernard's philosophical ambitions seriously, exploring his important, even central, role in the mental world of nineteenth-century France. This includes his influence on Henri Bergson (1859–1941) and other late-nineteenth century thinkers. The subtext of Bernard's experimental epistemology is also contrasted with a key idealist philosopher of the period, the German Arthur Schopenhauer (1788–1860), and placed in the context of the larger European philosophical sphere. In contrast to much of mid-nineteenth-century philosophy, Bernard, in creating the framework for experimental medicine, argued for an experimental approach in which a priori assumptions were to be strictly constrained. Bernard's thoughts on the nature of experiment put an end to "systems" in medicine, ironically by replacing all previous medical philosophies with the all-embracing "system" of experiment. And yet, while "vital forces" fade after Bernard, a form of vitalism still flourishes. Even in Bernard's own work, in the struggle with concepts like determinism, complexity, and causality, there is a realization of the unique character of living function in a kind of "physical vitalism."

Recent Dissertations in the History of Medicine

2007-09-05

HUGH TREVOR-ROPER. Europe's Physician: The Various Life of Sir Theodore de Mayerne. New Haven, Connecticut, Yale University Press, 2006. xii, 438 pp., illus

Holmes, F. — 2007-09-05

GUENTER B. RISSE. New Medical Challenges during the Scottish Enlightenment. Amsterdam and New York, Radopi, 2005. vi, 386 pp. $96

Wood, P. — 2007-09-05

PHILIP CASH. Dr. Benjamin Waterhouse: A Life in Medicine and Public Service (1754-1846). Sagamore Beach, Massachusetts, Boston Medical Library & Science History Publications, 2006. xii, 516 pp., illus. $56

Rusnock, A. — 2007-09-05

ERIC T. JENNINGS. Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas. Durham, North Carolina, Duke University Press, 2006. xii, 272 pp., illus. $21.95

Keller, R. C. — 2007-09-05

ALAN M. KRAUT and DEBORAH A. KRAUT. Covenant of Care: Newark Beth Israel and the Jewish Hospital in America. New Brunswick New Jersey, Rutgers University Press, 2007. 328 pp., illus. $37.95 (cloth)

Barde, R. — 2007-09-05

CHARLES HAYTER. An Element of Hope: Radium and the Response to Cancer in Canada, 1900-1940. Montreal, McGill-Queen's University Press, 2005. xiv, 273 pp., illus. $70

Roland, C. G. — 2007-09-05

RICHARD DEGRANDPRE. The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture. DurhamNorth Carolina, Duke University Press, 2006. vii, 294 pp., illus. $24.95

Campbell, N. D. — 2007-09-05

JULIA RODRIGUEZ. Civilizing Argentina. Science Medicine and the Modern State. Chapel Hill, University of North Carolina Press, 2006. xii, 306 pp., illus. $24.95

Acuna, L. E. — 2007-09-05

Books Received

2007-09-05