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Medicine and Health > History of Medicine

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Deafness, community and culture in Britain

Leisure and cohesion, 1945–95

Martin Atherton

Sets a case study of deaf people’s leisure in NW England within a wider British context; gives insights into a misunderstood, misrepresented community; questions perceptions of deafness as a disability; shows the importance of shared leisure in community formation and how changing patterns of socialisation are affecting British society.

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Death Is That Man Taking Names

Intersections of American Medicine, Law, and Culture

Robert A. Burt

The American culture of death changed radically in the 1970s. For terminal illnesses, hidden decisions by physicians were rejected in favor of rational self-control by patients asserting their "right to die"—initially by refusing medical treatment and more recently by physician-assisted suicide. This new claim rested on two seemingly irrefutable propositions: first, that death can be a positive good for individuals whose suffering has become intolerable; and second, that death is an inevitable and therefore morally neutral biological event. Death Is That Man Taking Names suggests, however, that a contrary attitude persists in our culture—that death is inherently evil, not just in practical but also in moral terms. The new ethos of rational self-control cannot refute but can only unsuccessfully try to suppress this contrary attitude. The inevitable failure of this suppressive effort provokes ambivalence and clouds rational judgment in many people's minds and paradoxically leads to inflictions of terrible suffering on terminally ill people.

Judicial reforms in the 1970s of abortion and capital punishment were driven by similarly high valuations of rationality and public decision-making—rejecting physician control over abortion in favor of individual self-control by pregnant women and subjecting unsupervised jury decisions for capital punishment to supposed rationally guided supervision by judges. These reforms also attempt to suppress persistently ambivalent attitudes toward death, and are therefore prone to inflicting unjustified suffering on pregnant women and death-sentenced prisoners.

In this profound and subtle account of psychological and social forces underlying American cultural attitudes toward death, Robert A. Burt maintains that unacknowledged ambivalence is likely to undermine the beneficent goals of post-1970s reforms and harm the very people these changes were intended to help.

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Decadent Genealogies

The Rhetoric of Sickness from Baudelaire to D'Annunzio

Barbara Spackman

Barbara Spackman here examines the ways in which decadent writers adopted the language of physiological illness and alteration as a figure for psychic otherness. By means of an ideological and rhetorical analysis of scientific as well as literary texts, she shows how the rhetoric of sickness provided the male decadent writer with an alibi for the occupation and appropriation of the female body.

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Deliver Me from Pain

Anesthesia and Birth in America

Jacqueline H. Wolf

Despite today's historically low maternal and infant mortality rates in the United States, labor continues to evoke fear among American women. Rather than embrace the natural childbirth methods promoted in the 1970s, most women welcome epidural anesthesia and even Cesarean deliveries. In Deliver Me from Pain, Jacqueline H. Wolf asks how a treatment such as obstetric anesthesia, even when it historically posed serious risk to mothers and newborns, paradoxically came to assuage women's anxiety about birth. Each chapter begins with the story of a birth, dramatically illustrating the unique practices of the era being examined. Deliver Me from Pain covers the development and use of anesthesia from ether and chloroform in the mid-nineteenth century; to amnesiacs, barbiturates, narcotics, opioids, tranquilizers, saddle blocks, spinals, and gas during the mid-twentieth century; to epidural anesthesia today. Labor pain is not merely a physiological response, but a phenomenon that mothers and physicians perceive through a historical, social, and cultural lens. Wolf examines these influences and argues that medical and lay views of labor pain and the concomitant acceptance of obstetric anesthesia have had a ripple effect, creating the conditions for acceptance of other, often unnecessary, and sometimes risky obstetric treatments: forceps, the chemical induction and augmentation of labor, episiotomy, electronic fetal monitoring, and Cesarean section. As American women make decisions about anesthesia today, Deliver Me from Pain offers them insight into how women made this choice in the past and why each generation of mothers has made dramatically different decisions.

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Diagnosis, Therapy, and Evidence

Conundrums in Modern American Medicine

Gerald N. Grob and Allan V. Horwitz

In Diagnosis, Therapy, and Evidence, Gerald N. Grob and Allan V. Horwitz employ historical and contemporary data and case studies, combining into one book a variety of medical and psychiatric conditions. They utilize case studies and examine tonsillectomy, cancer, heart disease, PTSD, anxiety, and depression, and identify differences between rhetoric and reality and the weaknesses in diagnosis and treatment.

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Disease and Discovery

A History of the Johns Hopkins School of Hygiene and Public Health, 1916–1939

Elizabeth Fee

At the end of the nineteenth century, public health was the province of part-time political appointees and volunteer groups of every variety. Public health officers were usually physicians, but they could also be sanitary engineers, lawyers, or chemists—there was little agreement about the skills and knowledge necessary for practice. In Disease and Discovery, Elizabeth Fee examines the conflicting ideas about public health’s proper subject and scope and its search for a coherent professional unity and identity. She draws on the debates and decisions surrounding the establishment of what was initially known as the Johns Hopkins School of Hygiene and Public Health, the first independent institution for public health research and education, to crystallize the fundamental questions of the field.

Many of the issues of public health education in the early twentieth century are still debated today. What is the proper relationship of public health to medicine? What is the relative importance of biomedical, environmental, and sociopolitical approaches to public health? Should schools of public health emphasize research skills over practical training? Should they provide advanced training and credentials for the few or simpler educational courses for the many?

Fee explores the many dimensions of these issues in the context of the founding of the Johns Hopkins school. She details the efforts to define the school’s structure and purpose, select faculty and students, and organize the curriculum, and she follows the school’s growth and adaptation to the changing social environment through the beginning of World War II. As Fee demonstrates, not simply in its formation but throughout its history the School of Hygiene served as a crucible for the forces shaping the public health profession as a whole.

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Disease Prevention as Social Change

The State, Society, and Public Health in the United States, France, Great Britain, and Canada

From mad-cow disease and E. coli-tainted spinach in the food supply to anthrax scares and fears of a bird flu pandemic, national health threats are a perennial fact of American life. Yet not all crises receive the level of attention they seem to merit. The marked contrast between the U.S. government’s rapid response to the anthrax outbreak of 2001 and years of federal inaction on the spread of AIDS among gay men and intravenous drug users underscores the influence of politics and public attitudes in shaping the nation’s response to health threats. In Disease Prevention as Social Change, sociologist Constance Nathanson argues that public health is inherently political, and explores the social struggles behind public health interventions by the governments of four industrialized democracies. Nathanson shows how public health policies emerge out of battles over power and ideology, in which social reformers clash with powerful interests, from dairy farmers to tobacco lobbyists to the Catholic Church. Comparing the history of four public health dilemmas—tuberculosis and infant mortality at the turn of the last century, and more recently smoking and AIDS—in the United States, France, Britain, and Canada, Nathanson examines the cultural and institutional factors that shaped reform movements and led each government to respond differently to the same health challenges. She finds that concentrated political power is no guarantee of government intervention in the public health domain. France, an archetypical strong state, has consistently been decades behind other industrialized countries in implementing public health measures, in part because political centralization has afforded little opportunity for the development of grassroots health reform movements. In contrast, less government centralization in America has led to unusually active citizen-based social movements that campaigned effectively to reduce infant mortality and restrict smoking. Public perceptions of health risks are also shaped by politics, not just science. Infant mortality crusades took off in the late nineteenth century not because of any sudden rise in infant mortality rates, but because of elite anxieties about the quantity and quality of working-class populations. Disease Prevention as Social Change also documents how culture and hierarchies of race, class, and gender have affected governmental action—and inaction—against particular diseases. Informed by extensive historical research and contemporary fieldwork, Disease Prevention as Social Change weaves compelling narratives of the political and social movements behind modern public health policies. By comparing the vastly different outcomes of these movements in different historical and cultural contexts, this path-breaking book advances our knowledge of the conditions in which social activists can succeed in battles over public health.

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Doctoring Freedom

The Politics of African American Medical Care in Slavery and Emancipation

Gretchen Long

For enslaved and newly freed African Americans, attaining freedom and citizenship without health for themselves and their families would have been an empty victory. Even before emancipation, African Americans recognized that control of their bodies was a critical battleground in their struggle for autonomy, and they devised strategies to retain at least some of that control. In Doctoring Freedom, Gretchen Long tells the stories of African Americans who fought for access to both medical care and medical education, showing the important relationship between medical practice and political identity.

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Doctoring the South

Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century

Steven M. Stowe

Offering a new perspective on medical progress in the nineteenth century, Steven M. Stowe provides an in-depth study of the midcentury culture of everyday medicine in the South. Reading deeply in the personal letters, daybooks, diaries, bedside notes, and published writings of doctors, Stowe illuminates an entire world of sickness and remedy, suffering and hope, and the deep ties between medicine and regional culture. In a distinct American region where climate, race and slavery, and assumptions about "southernness" profoundly shaped illness and healing in the lives of ordinary people, Stowe argues that southern doctors inhabited a world of skills, medicines, and ideas about sickness that allowed them to play moral, as well as practical, roles in their communities. Looking closely at medical education, bedside encounters, and medicine's larger social aims, he describes a "country orthodoxy" of local, social medical practice that highly valued the "art" of medicine. While not modern in the sense of laboratory science a century later, this country orthodoxy was in its own way modern, Stowe argues, providing a style of caregiving deeply rooted in individual experience, moral values, and a consciousness of place and time. In this deeply researched study of white country doctors in the mid-nineteenth-century South, Stowe examines their training, practice, and reflective writing. In three parts, the book investigates the education doctors received; doctor/patient relationships and the related dynamics of race, economics, and community structure; and how doctors wrote about and understood the wider meaning of their work. Stowe's argument centers on the rural practice of medicine; the fluid boundary between "orthodox" practice and the vernacular practice of midwives, healers, herbalists, and family members; and the ways in which race did and didn't enter the spheres of sickness and healing. Stowe examines the role of the white country doctor in the mid-nineteenth-century South and explores what their training, their practice, and their writings tell us about community and culture in the rural antebellum South. Offering a new perspective on medical progress in the nineteenth century, Steven M. Stowe provides an in-depth study of the midcentury culture of everyday medicine in the South. Reading deeply in the personal letters, daybooks, diaries, bedside notes, and published writings of doctors, Stowe illuminates an entire world of sickness and remedy, suffering and hope, and the deep ties between medicine and regional culture. In a distinct American region where climate, race and slavery, and assumptions about "southernness" profoundly shaped illness and healing in the lives of ordinary people, Stowe argues that southern doctors inhabited a world of skills, medicines, and ideas about sickness that allowed them to play moral, as well as practical, roles in their communities. Looking closely at medical education, bedside encounters, and medicine's larger social aims, he describes a "country orthodoxy" of local, social medical practice that highly valued the "art" of medicine. While not modern in the sense of laboratory science a century later, this country orthodoxy was in its own way modern, Stowe argues, providing a style of caregiving deeply rooted in individual experience, moral values, and a consciousness of place and time.

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Doctors at War

Life and Death in a Field Hospital

Mark de Rond

Doctors at War is a candid account of a trauma surgical team based, for a tour of duty, at a field hospital in Helmand, Afghanistan. Mark de Rond tells of the highs and lows of surgical life in hard-hitting detail, bringing to life a morally ambiguous world in which good people face impossible choices and in which routines designed to normalize experience have the unintended effect of highlighting war's absurdity. With stories that are at once comical and tragic, de Rond captures the surreal experience of being a doctor at war. He lifts the cover on a world rarely ever seen, let alone written about, and provides a poignant counterpoint to the archetypical, adrenaline-packed, macho tale of what it is like to go to war.

Here the crude and visceral coexist with the tender and affectionate. The author tells of well-meaning soldiers at hospital reception, there to deliver a pair of legs in the belief that these can be reattached to their comrade, now in mid-surgery; of midsummer Christmas parties and pancake breakfasts and late-night sauna sessions; of interpersonal rivalries and banter; of caring too little or too much; of tenderness and compassion fatigue; of hell and redemption; of heroism and of playing God. While many good firsthand accounts of war by frontline soldiers exist, this is one of the first books ever to bring to life the experience of the surgical teams tasked with mending what war destroys.

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