This article reconstructs the diagnostic act of the French pox in the French-disease hospital of sixteenth-century Augsburg. It focuses on how the participants in the clinical encounter imagined the configuration of the pox and its localization in the human body. Of central importance for answering this question is the early modern conception of physical signs. It has been argued that it was due to a specific understanding of bodily signs and their relationship to a disease and its causes, that disease definition and classification in the early modern period showed a high degree of flexibility and fluidity. This paper looks at how the sixteenth-century theoretical conception of physical signs not only shaped the diagnosis and treatment of the pox but also reflected the overall organization of institutions.
This essay examines the medical debates over hereditary disease and moral hygiene in France between 1748 and 1790. During this time, which was marked by two formal academic exchanges about pathological inheritance, doctors critically studied the existence of hereditary diseases—including syphilis, arthritis, phthisis, scrofula, rickets, gout, stones, epilepsy, and insanity—and the problems that heredity might pose for curing and preventing these diseases. Amid public debate, doctors first treated heredity with formal skepticism and then embraced the idea. Their changing attitudes stemmed less from epistemological or cognitive reasons than from new cultural beliefs about gender, domesticity, and demographic policy. Fearing moral degeneracy and demographic decline, they argued that a number of social pathologies were truly hereditary and that these diseases spread within the family itself. These beliefs were seemingly confirmed by new clinical studies on tuberculosis. Though doctors conceded that hereditary diseases might limit Enlightenment hopes to perfect society, they also suggested that sexual hygiene and physical education could cure hereditary degeneracy and transcend genealogy and descent. Consequently, they stressed that physical regeneration was a dynamic process, one that stretched from the conjugal bed to weaning and beyond. Rather than accepting the accidents of birth, physicians believed that their patients could self-consciously overcome inherited defects and thus regenerate themselves and even all of society itself. Heredity thus gave doctors an idiom with which to diagnose a felt social crisis and to prescribe appropriate hygienic responses.
Like the English, Virginians tended to think that idiocy, a condition analogous to intellectual disability in the twenty-first century, was congenital, untreatable, and incurable, and they adopted legal remedies that corresponded closely to the laws of England. In addition, concepts of idiocy reflected some of the unique aspects of Virginia's social system, which was dominated by a coterie of powerful men. With a need to preserve social order and maintain decorum, the Virginia legislature established in 1769 the Eastern State Hospital to house unruly and objectionable people who were mentally disabled. Although idiots were among the hospital's first patients, they were eventually banished due to their presumed failure to respond to treatment. The social stigma attached to idiocy extended from Virginia's city streets and jails to the private homes of prominent families. Personal reticence regarding shameful family matters hid the identity of people thought to be intellectually disabled. Even Thomas Jefferson, a prolific author, entered only cryptic notes about the limitations of his sister, Elizabeth. In summary, Virginians' response to idiocy suggests a two-tiered approach: public disclosure and disdain of poor and dependent people with intellectual disabilities, and silent avoidance of the problem in prominent families. In both situations, idiocy represented images of shame and humiliation that threatened the social order.
In Britain in 1830, nuisances legally comprised a heterogeneous collection of irritants, united by their ability to cause hurt, inconvenience, or damage. The only legal remedies for nuisances that applied to the entire country were provided through the common law. Though respected, common-law procedure was time consuming, costly, uncertain, and intended to protect the enjoyment of property, not of health. Dangers to health could be removed if they were a nuisance, yet health hazards were not conceptualized separately from nuisances in general, nor were they dealt with differently in practice. This paper demonstrates that during the 1831–32 cholera epidemic, and again in 1846, the executive and the legislature created a strictly medicalized health hazard as part of the transformation in nuisance law and practice. The paper argues, however, that the creation of a medicalized health hazard was a defensive reaction on the part of central authorities. Indeed, after 1846 Parliament retreated from a strictly medicalized health hazard in the face of local resistance and skepticism, and by 1855 physicians played only a marginal and supporting role in nuisance practice. The development of nuisance law thus illustrates the local inspiration for sanitary reform and the often highly contested nature of central interventions.
During the 1950s, Staphylococcusaureus became a major source of hospital infections and death, particularly in neonates. This situation was further complicated by the fact that Staphylococcus quickly gained resistance to most antibiotics. Controlling these infections was a pressing concern for hospital workers, especially bacteriologists who tackled it through the use of a new epidemiologic tool: phage typing. This article argues that during the mid- to late 1950s a series of staphylococcal hospital and nursery epidemics united phage typers, brought international recognition to the usefulness of their technique, and, in the process, contributed to the establishment of the new field of infection control. Through the use of this new tool, phage typers established themselves as experts in infection control and, in some places, became essential members of newly formed infection-control committees. The nursery epidemics represent a particularly important test for phage typing and infection control, for this staphylococcal strain (80/81) was especially virulent and spread rapidly beyond the hospital to the wider community. The epidemiologic information provided by phage typers was vital for devising practical advice on how to control this deadly strain of Staphylococcus and also for transforming the role of the hospital bacteriologist from mere technician into infection-control expert.