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Medicine and Health > History of Medicine

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Epidemic City Cover

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Epidemic City

The Politics of Public Health in New York

The first permanent Board of Health in the United States was created in response to a cholera outbreak in New York City in 1866. By the mid-twentieth century, thanks to landmark achievements in vaccinations, medical data collection, and community health, the NYC Department of Health had become the nation’s gold standard for public health. However, as the city’s population grew in number and diversity, the department struggled to balance its efforts between the treatment of diseases—such as AIDS, tuberculosis, and West Nile Virus—and the prevention of illness-causing factors like lead paint, heroin addiction, homelessness, smoking, and unhealthy foods. In Epidemic City, historian of public health James Colgrove chronicles the challenges faced by the health department since New York City’s mid-twentieth-century “peak” in public health provision. This insightful volume draws on archival research and oral histories to examine how the provision of public health has adapted to the competing demands of diverse public needs, public perceptions, and political pressure. Epidemic City analyzes the perspectives and efforts of the people responsible for the city’s public health from the 1960s to the present—a time that brought new challenges, such as budget and staffing shortages, and new threats like bioterrorism. Faced with controversies such as needle exchange programs and AIDS reporting, the health department struggled to maintain a delicate balance between its primary focus on illness prevention and the need to ensure public and political support for its activities. In the past decade, after the 9/11 attacks and bioterrorism scares partially diverted public health efforts from illness prevention to threat response, Mayor Michael Bloomberg and Health Commissioner Thomas Frieden were still able to pass New York’s Clean Indoor Air Act restricting smoking and significant regulations on trans-fats used by restaurants. This legislation—preventative in nature much like the department’s original sanitary code—reflects a return to the nineteenth century roots of public health, when public health measures were often overtly paternalistic. The assertive laws conceived by Frieden and executed by Bloomberg demonstrate how far the mandate of public health can extend when backed by committed government officials. Epidemic City provides a compelling historical analysis of the individuals and groups tasked with negotiating the fine line between public health and political considerations. By examining the department’s successes and failures during the ambitious social programs of the 1960s, the fiscal crisis of the 1970s, the struggles with poverty and homelessness in the 1980s and 1990s, and in the post-9/11 era, Epidemic City shows how the NYC Department of Health has defined the role and scope of public health services for the entire nation.

The Estrogen Elixir Cover

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The Estrogen Elixir

A History of Hormone Replacement Therapy in America

Elizabeth Siegel Watkins

In the first complete history of hormone replacement therapy (HRT), Elizabeth Siegel Watkins illuminates the complex and changing relationship between the medical treatment of menopause and cultural conceptions of aging. Describing the development, spread, and shifting role of HRT in America from the early twentieth century to the present, Watkins explores how the interplay between science and society shaped the dissemination and reception of HRT and how the medicalization—and subsequent efforts toward the demedicalization—of menopause and aging affected the role of estrogen as a medical therapy. Telling the story from multiple perspectives—physicians, pharmaceutical manufacturers, government regulators, feminist health activists, and the media, as well as women as patients and consumers—she reveals the striking parallels between estrogen’s history as a medical therapy and broad shifts in the role of medicine in an aging society. Today, information about HRT is almost always accompanied by a laundry list of health risks. While physicians and pharmaceutical companies have striven to develop the safest possible treatment for the symptoms of menopause and aging, many specialists question whether HRT should be prescribed at all. Drawing from a wide range of scholarly research, archival records, and interviews, The Estrogen Elixir provides valuable historical context for one of the most pressing debates in contemporary medicine. Praise for Watkins' On the Pill: "An exemplary study of how the nation which first had access to oral contraceptives first came to terms with their advantages, and their drawbacks."—Times Literary Supplement "Intelligent and well-structured . . . An admirable exercise in social history."—Nature "A particularly fascinating issue, trim and focused, sophisticated and helpful, fresh and very interesting."—American Historical Review "In every carefully organized, lucidly written chapter Watkins provides surprising corrections to conventional thinking about the new birth control method."—Journal of American History "Anyone concerned with the debate over scientific advance and medical authority will find this a highly stimulating study."—Journal of American Studies

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The Evolution of Obesity

Michael L. Power and Jay Schulkin

In this sweeping exploration of the relatively recent obesity epidemic, Michael L. Power and Jay Schulkin probe evolutionary biology, history, physiology, and medical science to uncover the causes of our growing girth. The unexpected answer? Our own evolutionary success. For most of the past few million years, our evolutionary ancestors' survival depended on being able to consume as much as possible when food was available and to store the excess energy for periods when it was scarce. In the developed world today, high-calorie foods are readily obtainable, yet the propensity to store fat is part of our species' heritage, leaving an increasing number of the world's people vulnerable to obesity. In an environment of abundant food, we are anatomically, physiologically, metabolically, and behaviorally programmed in a way that makes it difficult for us to avoid gaining weight. Power and Schulkin’s engagingly argued book draws on popular examples and sound science to explain our expanding waistlines and to discuss the consequences of being overweight for different demographic groups. They review the various studies of human and animal fat use and storage, including those that examine fat deposition and metabolism in men and women; chronicle cultural differences in food procurement, preparation, and consumption; and consider the influence of sedentary occupations and lifestyles. A compelling and comprehensive examination of the causes and consequences of the obesity epidemic, The Evolution of Obesity offers fascinating insights into the question, Why are we getting fatter?

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Febris Erotica

Lovesickness in the Russian Literary Imagination

by Valeria Sobol

The destructive power of obsessive love was a defining subject of eighteenth- and nineteenth-century Russian literature. In Febris Erotica, Sobol argues that Russian writers were deeply preoccupied with the nature of romantic relationships and were persistent in their use of lovesickness not simply as a traditional theme but as a way to address pressing philosophical, ethical, and ideological concerns through a recognizable literary trope. Sobol examines stereotypes about the damaging effects of romantic love and offers a short history of the topos of lovesickness in Western literature and medicine.

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The Fertility Doctor

John Rock and the Reproductive Revolution

Margaret Marsh and Wanda Ronner

As Louise Brown—the first baby conceived by in vitro fertilization—celebrates her 30th birthday, Margaret Marsh and Wanda Ronner tell the fascinating story of the man who first showed that human in vitro fertilization was possible. John Rock spent his career studying human reproduction. The first researcher to fertilize a human egg in vitro in the 1940s, he became the nation’s leading figure in the treatment of infertility, his clinic serving rich and poor alike. In the 1950s he joined forces with Gregory Pincus to develop oral contraceptives and in the 1960s enjoyed international celebrity for his promotion of the pill and his campaign to persuade the Catholic Church to accept it. Rock became a more controversial figure by the 1970s, as conservative Christians argued that his embryo studies were immoral and feminist activists contended that he had taken advantage of the clinic patients who had participated in these studies as research subjects. Marsh and Ronner’s nuanced account sheds light on the man behind the brilliant career. They tell the story of a directionless young man, a saloon keeper’s son, who began his working life as a timekeeper on a Guatemalan banana plantation and later became one of the most recognized figures of the twentieth century. They portray his medical practice from the perspective of his patients, who ranged from the wives of laborers to Hollywood film stars. The first scholars to have access to Rock’s personal papers, Marsh and Ronner offer a compelling look at a man whose work defined the reproductive revolution, with its dual developments in contraception and technologically assisted conception.

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Fit to Be Tied

Sterilization and Reproductive Rights in America, 1950-1980

Rebecca M. Kluchin

Fit to Be Tied provides a history of sterilization and what would become, at once, socially divisive and a popular form of birth control. Utilizing first-person narratives, court cases, and official records, Rebecca M. Kluchin examines the evolution of forced sterilization of poor women, especially women of color, in the second half of the century and contrasts it with demands for contraceptive sterilization made by white women and men. She chronicles public acceptance during an era of reproductive and sexual freedom, the shift away from sterilization and how it influenced many aspects of American life.

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Florence Nightingale and Hospital Reform

Collected Works of Florence Nightingale, Volume 16

Florence Nightingale began working on hospital reform even before she founded her famous school of nursing; hospitals were dangerous places for nurses as well as patients, and they urgently needed fundamental reform. She continued to work on safer hospital design, location, and materials to the end of her working life, advising on plans for children’s, general, military, and convalescent hospitals and workhouse infirmaries.

Florence Nightingale and Hospital Reform, the final volume in the Collected Works of Florence Nightingale, includes her influential Notes on Hospitals, with its much-quoted musing on the need of a Hippocratic oath for hospitals—namely, that first they should do the sick no harm. Nightingale’s anonymous articles on hospital design are printed here also, as are later encyclopedia entries on hospitals.

Correspondence with architects, engineers, doctors, philanthropists, local notables, and politicians is included. The results of these letters, some with detailed critiques of hospital plans, can be seen initially in the great British examples of the new “pavilion” design—at St. Thomas’, London (a civil hospital), at the Herbert Hospital (military), and later at many hospitals throughout the UK and internationally. Nightingale’s insistence on keeping good statistics to track rates of mortality and hospital stays, and on using them to compare hospitals, can be seen as good advice for today, given the new versions of “hospital-acquired infections” she combatted.

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From Madness to Mental Health

Psychiatric Disorder and Its Treatment in Western Civilization

Edited and with an introduction by Greg Eghigian

In From Madness to Mental Health, Greg Eghigian has compiled a unique anthology of readings, from ancient times to the present, which also includes an updated bibliography of first-person narratives on mental illness compiled by Gail A. Hornstein. This work neither glorifies nor denigrates the contributions of psychiatry, clinical psychology, and psychotherapy, but rather considers how mental disorders have historically challenged the ways in which human beings have understood and valued their bodies, minds, and souls.

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Galen and the Rhetoric of Healing

Susan P. Mattern

Galen is the most important physician of the Roman imperial era. Many of his theories and practices were the basis for medical knowledge for centuries after his death and some practices—like checking a patient’s pulse—are still used today. He also left a vast corpus of writings which makes up a full one-eighth of all surviving ancient Greek literature. Through her readings of hundreds of Galen’s case histories, Susan P. Mattern presents the first systematic investigation of Galen’s clinical practice. Galen’s patient narratives illuminate fascinating interplay among the craft of healing, social class, professional competition, ethnicity, and gender. Mattern describes the public, competitive, and masculine nature of medicine among the urban elite and analyzes the relationship between clinical practice and power in the Roman household. She also finds that although Galen is usually perceived as self-absorbed and self-promoting, his writings reveal him as sensitive to the patient’s history, symptoms, perceptions, and even words. Examining his professional interactions in the context of the world in which he lived and practiced, Galen and the Rhetoric of Healing provides a fresh perspective on a foundational figure in medicine and valuable insight into how doctors thought about their patients and their practice in the ancient world.

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Gene Jockeys

Life Science and the Rise of Biotech Enterprise

Nicolas Rasmussen

The biotech arena emerged in the 1970s and 1980s, when molecular biology, one of the fastest-moving areas of basic science in the twentieth century, met the business world. Gene Jockeys is a detailed study of the biotech projects that led to five of the first ten recombinant DNA drugs to be approved for medical use in the United States: human insulin, human growth hormone, alpha interferon, erythropoietin, and tissue plasminogen activator. Drawing on corporate documents obtained from patent litigation, as well as interviews with the ambitious biologists who called themselves gene jockeys, historian Nicolas Rasmussen chronicles the remarkable, and often secretive, work of venture capitalists, stock market investors, and scientist-entrepreneurs who built a new domain between academia and the drug industry in the pursuit of intellectual rewards and big payouts. In contrast to some who critique the rise of biotechnology, Rasmussen contends that biotech was not a swindle, even if the public did pay a very high price for the development of what began as public scientific resources. Within the biotech enterprise, the work of corporate scientists went well beyond what biologists had already accomplished within universities, and it accelerated the medical use of the new drugs by several years. In his technically detailed but approachable narrative, Rasmussen focuses on the visible and often heavy hands that construct and maintain the markets in public goods like science. He looks closely at how science follows money, and vice versa, as researchers respond to the pressures and potential rewards of commercially viable innovations. In biotechnology, many of those who engaged in crafting markets for genetically engineered drugs were biologists themselves who were in fact trying to do science. This book captures that heady, fleeting moment when a biologist could expect to do great science through the private sector and be rewarded with both wealth and scientific acclaim.

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