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Bulletin of the History of Medicine 78.2 (2004) 516-518



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Esteban Rodríguez-Ocaña, ed. The Politics of the Healthy Life: An International Perspective. History of Medicine, Health, and Disease Series. Sheffield, U.K.: European Association for the History of Medicine and Health Publications, 2002. ix + 288 pp. £19.95 (EAMH members), £41.22 (nonmembers, U.S.A.), £34.95 (nonmembers, U.K.), £37.92 (nonmembers, Europe), £41.86 (nonmembers, elsewhere) (0-9536522-5-4).

This collection of essays is a welcome addition to the social medicine literature. With the exception of Gerry Kearns and Paul Laxton's "Ethnic Groups as Public Health Hazards," which explores how religious conflict affected Liverpool's handling of the hundreds of thousands of Irish refugees during the Great Irish Famine of 1847, the other papers in the collection pertain to the first half of the twentieth century. [End Page 516]

Pedro Samblás Tilve, in "Drug Use in Turn-of-the-Century Spain: From Freedom of Consumption to a Public Health Problem," maps how Spain moved from a society with unrestricted use of substances to one where they were tightly controlled by legislation. Pressured by the international community, with the United States leading the way, the Spanish government at first used doctors and pharmacists to control drug usage; this phase (1918-31) was followed by one (1931-39) where usage became illegal.

In "Shaping Industrial Health: The Debate on Asbestos Dust Hazards in the UK, 1928-39," Alfredo Menéndez Navarro deftly guides us through the complex story of how the early scientific definition and measurement of asbestos dust hazard delayed its being recognized as a zero-tolerance hazard. Risk was judged to be proportional to the length of exposure and to the level of dust concentration; thus those who later fell ill were denied compensation, for they were judged to have been exposed to less than what scientists considered the minimum threshold for any effect to be present.

Despite the Rockefeller Foundation's commitment to a preventive and curative approach to hookworm, their campaign in the Madras Presidency, 1920-28, as documented in Shirish N. Kavadi's "Wolves Come to Take Care of the Lamb," served as a laboratory for testing different anthelmintics for the treatment of hookworm, none of which was without problems. Victor Heiser, who initiated this project, only described the variable costs and efficacy of each drug in his book An American Doctor's Odyssey, concluding that "a tremendous step toward its [hookworm's] conquest will have been taken when it is stamped out in Madras" (p. 343).

During the Weimar Republic, social hygiene underwent a dramatic change as its leaders became caught up in the national concern with a population decline and diminishing work capacity. Earlier reform programs were "belittled as 'nonscientific'" (p. 168) in light of the new quantitative bases for judging the health of a "nation's body." How this came about is told in "People's Health and Nation's Body: The Modernization of Statistics, Demography and Social Hygiene in the Weimar Republic" by Gabriele Moser and Jochen Fleishhacker.

Paul Weindling's "From Moral Exhortation to the New Public Health, 1918-45" re-creates the interwar period of public health from his deep reading of the Milbank Memorial Fund archives. Particularly stressed are the works of Edgar Sydenstricker and C.-E. A. Winslow, who together strove to promote statistical and demographic analysis to measure health improvement. The "noble vision" (p. 127) that emerged from their work offered a model for the United States other than Europe's health insurance model.

Numerous child health initiatives emerged in the aftermath of World War One. John F. Hutchinson, in "Promoting Child Health in the 1920s: International Politics and the Limits of Humanitarianism," shows how each struggled to attract public funding and the support of both governmental and intergovernmental agencies. From this rich analysis emerges the extent to which nonhumanitarian criteria drove the different programs, including the desire to protect children today to avoid their becoming the "diseased and...

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