Small Matters: Canadian Children in Sickness and Health, 1900–1940by Mona Gleason (review)

Focusing on Canadian children’s embodied experiences of health and illness at a time when a variety of interrelated social anxieties converged around “the complex issue of child health,” Mona Gleason’s Small Matters: Canadian Children in Sickness and Health, 1900–1940makes important contributions to the existing literature on the history of the family, childhood, education, and medicine (p. 12). Positioning her study at the intersection of these various fields, Gleason, a leading historian of childhood in the Canadian context, uses a range of sources including professional medical writings, health curriculum textbooks, and patient records from Toronto’s Hospital for Sick Children to argue that “everyday engagement with sickness and health” played a significant role in shaping both children’s lives and their memories of growing up (p. 6). Particularly significant is her use of over thirty individual oral histories, selected from a larger pool of sixty-two interviews, where participants recounted their childhood recollections of “health, health care, learning to be healthy, illness, and medical treatment” (p. 159).

In the first decades of the twentieth century, a growing group of professional experts, including doctors, nurses, social workers, and educators, increasingly articulated a pathological view of children’s bodies. This construction, which framed the young body as inherently different and “not yet adult,” Gleason argues, served to “make unequal relations of power between children and adults sensible and ‘natural’” (p. 14). The first chapter of the book explores the medical profession’s role in this construction, focusing on how assumptions about the nature of childlike bodies guided both professional decision making and the development of pediatrics as a medical specialty. While all young bodies were problematic—Gleason suggests that “merely being small … required medical attention”—understandings of youthful pathologies were complicated by early twentieth-century attitudes toward gender, class, and race that brought “more finely calibrated meaning to the pathology associated with childhood” (p. 45). The following two chapters rely on childhood memories of both good and bad health, using oral histories as the primary source of evidence. In the first two decades of the 1900s, high rates of infant mortality, disease, and infection shaped much of the discourse on children’s health, as the containment and eradication of contagious disease were prioritized. During the interwar period, emphases shifted to prevention, as new “public health initiatives aimed at improving the health and welfare of Canadian families,” including well-baby clinics, milk pasteurization depots, and vaccination programs, were developed and consolidated (p. 67). Despite the increasing medicalization of child health throughout these decades, however, Gleason repeatedly demonstrates that so-called domestic doctoring did not disappear, but was, rather, increasingly seen as something that needed to be supervised by the “modern” mainstream medical profession (p. 84). Chapters in the second half of the book take a thematic approach, exploring the role of public school health curricula in shaping and disseminating official standards of healthy living and “embodied democratic citizenship” (p. 97), children’s varying memories and experiences of “the institutional setting of the hospital” (p. 105), and the construction of “the disabled child” as a uniquely difficult challenge to “good health,” “normalcy,” and the nation (pp. 120, 133). Despite the obvious power relationships at play, Gleason argues that children were able to exercise their own forms of “knee-high agency” to challenge medical decision making and support their own interests, with varying degrees of success (p. 115). While racial, ethnic, and linguistic differences in experience could be more fully borne out in her study, Gleason clearly demonstrates that those children and families “deemed at odds with white, middle-class values” were consistently the targets of public health measures and surveillance (p. 140).

Well situated in both national and international scholarship, Gleason’s work makes an impressive case for the significance of size and age as important...