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Johns Hopkins Biographies of Disease

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Johns Hopkins Biographies of Disease

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Aging Bones

A Short History of Osteoporosis

Gerald N. Grob

In the middle of the twentieth century, few physicians could have predicted that the modern diagnostic category of osteoporosis would emerge to include millions of Americans, predominantly older women. Before World War II, popular attitudes held that the declining physical and mental health of older persons was neither preventable nor reversible and that older people had little to contribute. Moreover, the physiological processes that influenced the health of bones remained mysterious. In Aging Bones, Gerald N. Grob makes a historical inquiry into how this one aspect of aging came to be considered a disease. During the 1950s and 1960s, as more and more people lived to the age of 65, older people emerged as a self-conscious group with distinct interests, and they rejected the pejorative concept of senescence. But they had pressing health needs, and preventing age-related decline became a focus for researchers and clinicians alike. In analyzing how the normal aging of bones was transformed into a medical diagnosis requiring treatment, historian of medicine Grob explores developments in medical science as well as the social, intellectual, economic, demographic, and political changes that transformed American society in the post–World War II decades. Though seemingly straightforward, osteoporosis and its treatment are shaped by illusions about the conquest of disease and aging. These illusions, in turn, are instrumental in shaping our health care system. While bone density tests and osteoporosis treatments are now routinely prescribed, aggressive pharmaceutical intervention has produced results that are inconclusive at best. The fascinating history in Aging Bones will appeal to students and scholars in the history of medicine, health policy, gerontology, endocrinology, and orthopedics, as well as anyone who has been diagnosed with osteoporosis.

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Anxiety

A Short History

Allan V. Horwitz

More people today report feeling anxious than ever before—even while living in relatively safe and prosperous modern societies. Almost one in five people experiences an anxiety disorder each year, and more than a quarter of the population admits to an anxiety condition at some point in their lives. Here Allan V. Horwitz, a sociologist of mental illness and mental health, narrates how this condition has been experienced, understood, and treated through the ages—from Hippocrates, through Freud, to today. Anxiety is rooted in an ancient part of the brain, and our ability to be anxious is inherited from species far more ancient than humans. Anxiety is often adaptive: it enables us to respond to threats. But when normal fear yields to what psychiatry categorizes as anxiety disorders, it becomes maladaptive. As Horwitz explores the history and multiple identities of anxiety—melancholia, nerves, neuroses, phobias, and so on—it becomes clear that every age has had its own anxieties and that culture plays a role in shaping how anxiety is expressed.

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The Housing Bomb

Why Our Addiction to Houses Is Destroying the Environment and Threatening Our Society

M. Nils Peterson, Tarla Rai Peterson, and Jianguo Liu

Have we built our way to ruin? Is your desire for that beach house or cabin in the woods part of the environmental crisis? Do you really need a bigger home? Why don’t multiple generations still live under one roof? In The Housing Bomb, leading environmental researchers M. Nils Peterson, Tarla Rai Peterson, and Jianguo Liu sound the alarm, explaining how and why our growing addiction to houses has taken the humble American dream and twisted it into an environmental and societal nightmare. Without realizing how much a contemporary home already contributes to environmental destruction, most of us want bigger and bigger houses and dream of the day when we own not just one dwelling but at least the two our neighbor does. We push our children to "get out on their own" long before they need to, creating a second household where previously one existed. We pave and build, demolishing habitat needed by threatened and endangered species, adding to the mounting burden of global climate change, and sucking away resources much better applied to pressing societal needs. “Reduce, reuse, recycle” is seldom evoked in the housing world, where economists predict financial disasters when "new housing starts" are reduced and the idea of renovating inner city residences is regarded as merely a good cause. Presenting irrefutable evidence, this book cries for America and the world to intervene by making simple changes in our household energy and water usage and by supporting municipal, state, national, and international policies to counter this devastation and overuse of resources. It offers a way out of the mess we are creating and envisions a future where we all live comfortable, nondestructive lives. The “housing bomb” is ticking, and our choice is clear—change our approach or feel the blast.

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Intolerant Bodies

A Short History of Autoimmunity

Warwick Anderson and Ian R. Mackay

Autoimmune diseases, which affect 5 to 10 percent of the population, are as unpredictable in their course as they are paradoxical in their cause. They produce persistent suffering as they follow a drawn-out, often lifelong, pattern of remission and recurrence. Multiple sclerosis, lupus, rheumatoid arthritis, and type 1 diabetes—the diseases considered in this book—are but a handful of the conditions that can develop when the immune system goes awry. Intolerant Bodies is a unique collaboration between Ian Mackay, one of the prominent founders of clinical immunology, and Warwick Anderson, a leading historian of twentieth-century biomedical science. The authors narrate the changing scientific understanding of the cause of autoimmunity and explore the significance of having a disease in which one’s body turns on itself. The book unfolds as a biography of a relatively new concept of pathogenesis, one that was accepted only in the 1950s. In their description of the onset, symptoms, and course of autoimmune diseases, Anderson and Mackay quote from the writings of Charles Dickens, Edgar Allan Poe, Joseph Heller, Flannery O’Connor, and other famous people who commented on or grappled with autoimmune disease. The authors also assess the work of the dedicated researchers and physicians who have struggled to understand the mysteries of autoimmunity. Connecting laboratory research, clinical medicine, social theory, and lived experience, Intolerant Bodies reveals how doctors and patients have come to terms, often reluctantly, with this novel and puzzling mechanism of disease causation.

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Marrow of Tragedy

The Health Crisis of the American Civil War

Margaret Humphreys

The Civil War was the greatest health disaster the United States has ever experienced, killing more than a million Americans and leaving many others invalided or grieving. Poorly prepared to care for wounded and sick soldiers as the war began, Union and Confederate governments scrambled to provide doctoring and nursing, supplies, and shelter for those felled by warfare or disease. During the war soldiers suffered from measles, dysentery, and pneumonia and needed both preventive and curative food and medicine. Family members—especially women—and governments mounted organized support efforts, while army doctors learned to standardize medical thought and practice. Resources in the north helped return soldiers to battle, while Confederate soldiers suffered hunger and other privations and healed more slowly, when they healed at all. In telling the stories of soldiers, families, physicians, nurses, and administrators, historian Margaret Humphreys concludes that medical science was not as limited at the beginning of the war as has been portrayed. Medicine and public health clearly advanced during the war—and continued to do so after military hostilities ceased.

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More Than Hot

A Short History of Fever

Christopher Hamlin

Christopher Hamlin’s magisterial work engages a common experience—fever—in all its varieties and meanings. Reviewing the representations of that condition from ancient times to the present, More Than Hot is a history of the world through the lens of fever. The book deals with the expression of fever, with the efforts of medical scientists to classify it, and with fever’s changing social, cultural, and political significance. Long before there were thermometers to measure it, people recognized fever as a dangerous if transitory state of being. It was the most familiar form of alienation from the normal self, a concern to communities and states as well as to victims, families, and healers. The earliest medical writers struggled for a conceptual vocabulary to explain fever. During the Enlightenment, the idea of fever became a means to acknowledge the biological experiences that united humans. A century later, in the age of imperialism, it would become a key element of conquest, both an important way of differentiating places and races, and of imposing global expectations of health. Ultimately the concept would split: "fevers" were dangerous and often exotic epidemic diseases, while “fever” remained a curious physiological state, certainly distressing but usually benign. By the end of the twentieth century, that divergence divided the world between a global south profoundly affected by fevers—chiefly malaria—and a north where fever, now merely a symptom, was so medically trivial as to be transformed into a familiar motif of popular culture. A senior historian of science and medicine, Hamlin shares stories from individuals—some eminent, many forgotten—who exemplify aspects of fever: reflections of the fevered, for whom fevers, and especially the vivid hallucinations of delirium, were sometimes transformative; of those who cared for them (nurses and, often, mothers); and of those who sought to explain deadly epidemic outbreaks. Significant also are the arguments of the reformers, for whom fever stood as a proxy for manifold forms of injustice. Broad in scope and sweep, Hamlin’s study is a reflection of how the meanings of diseases continue to shift, affecting not only the identities we create but often also our ability to survive.

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The PKU Paradox

A Short History of a Genetic Disease

Diane B. Paul and Jeffrey P. Brosco

PKU (phenylketonuria) is a genetic disorder that causes severe cognitive impairment if it is not detected and treated with a strict and difficult diet. In a lifetime of practice, most physicians will never encounter a single case of PKU, yet every physician in the industrialized world learns about the disease in medical school and, since the early 1960s, the newborn heel stick test for PKU has been mandatory in many countries. Diane B. Paul and Jeffrey P. Brosco’s beautifully written book explains this paradox. The development of state programs for early detection of and treatment for PKU is deservedly considered a great public health success story. Advocates have traded on this success to urge expanded newborn screening, to defend basic research in genetics, and to confront proponents of genetic determinism. When deployed for these purposes, treatment for PKU is typically represented as a simple matter of adhering to a low-phenylalanine diet. In reality, the challenges of living with PKU are daunting. In this first general history of PKU, a historian and a pediatrician explore how a rare genetic disease became the object of an unprecedented system for routine testing. The PKU Paradox is informed by interviews with scientists, clinicians, policy makers, and individuals who live with the disease. The questions it raises touch on ongoing controversies about newborn screening and what happens to blood samples collected at birth.

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