Medical History最新文献

Historians have written copiously about the shift to 'germ theories' of disease around the turn of the twentieth century, but in these accounts an entire continent has been left out: Antarctica. This article begins to rebalance our historiography by bringing cold climates back into the story of environmental medicine and germ theory. It suggests three periods of Antarctic (human) microbial research - heroic sampling, systematic studies, and viral space analogue - and examines underlying ideas about 'purity' and infection, the realities of fieldwork, and the use of models in biomedicine. It reveals Antarctica not as an isolated space but as a deeply complex, international, well-networked node in global science ranging from the first international consensus on pandemic-naming through to space flight.

Historical research on efforts to reduce the stigma associated with venereal disease (VD) generally dates these campaigns back to the 1930s. Within the United States, one of the earliest attempts to detach VD from its traditional association with sexual immorality occurred during the late nineteenth- and early twentieth-century, when the New York City dermatologist Lucius Bulkley coined the term syphilis insontium ('syphilis of the innocent') in the hopes of demonstrating that many of those who contracted this disease did so through non-sexual contact. Gaining widespread acceptance within the medical community, Bulkley's ideas served as the intellectual foundation for a discursive assault on the prevailing belief that syphilis constituted the 'wages of sin'-one designed to destigmatise the disease and to promote more scientific responses to it. However, the effects of this anti-stigma rhetoric were often counterproductive. Encouraging doctors to discern 'innocence' or 'guilt' through assessments of a patient's character, syphilis insontium often amplified the disease's association with immorality. With the passage of time, physicians became increasingly aware of these problems, and in the 1910s, a backlash against Bulkley's ideas emerged within the American medical community. Yet even with the resultant demise of his destigmatisation campaign, discourses of 'innocent syphilis' continued to circulate, casting a long shadow over subsequent stigma reduction efforts.

This article primarily concentrates on the theoretical and intellectual dimensions of nature cure, particularly efforts to revive it during the second half of the nineteenth century. Little is known about specific medical professionals or theories concerning the Victorian philosophy of nature cure, although this philosophy is mentioned in general terms in studies on alternative medicine and hygiene. This article illuminates a Victorian nature cure philosophy through the works of Edward W. Lane (1823-1889). As a physician and hydropathist, Lane aspired to create a new form of medical system, 'hygienic medicine', seeking answers to the questions 'What is disease?' and 'What is medicine?' throughout his career. Lane was among many physicians interested in nature's healing power during his time. However, few undertook as thorough a theorisation of nature cure philosophy as Lane did in the latter half of the nineteenth century, a period that presented unprecedented challenges in reconciling medicine with nature. This study explores the subtle nuances of the concepts that Lane actively used in his theoretical explanations, including 'nature', 'laws of health' and 'vital force', interpreting his efforts as a reconciliation between Romantic naturalism and laboratory medicine. The aim of this study is not to re-evaluate the significance of Lane's medical theory itself. It rather uses Lane as a lens to reveal the intricacies of Victorian nature cure philosophy.

This investigation sheds light on the social history of pathogenic dirt and its significance for shaping medical practices during the nineteenth century. It consists of an analysis focusing on Swedish medicine, using 8800 yearly reports written 1820-1900 by Swedish provincial doctors for the National Board of Health in Stockholm. The main argument is that the provincial doctors' perceptions of the relationship between dirt and health during this century can be better understood by focusing on similarities in the handling of different kinds of pathological dirt over the course of many decades, rather than seeing interest in cleanliness as something mostly unprecedented. A novel cleanliness regime became dominant during the latter third of the century, meant to counter a new hybrid between everyday dirt - bodily emanations from healthy bodies - and matter believed to have caused miasmatic and contagionistic disease. New ideas about filth and its impact on health played a crucial role in the development of public health and sanitation movements, and were a precondition for everyday dirt becoming a central medical problem around the turn of the twentieth century, but as is shown, they built on old precedents. Thus, the miasmatic and contagionistic approach to disease shaped conceptions of hygiene and cleanliness.

This article focuses on the circulation of knowledge about epilepsy in Sweden between 1915 and 1940. During the period medical research on epilepsy increased, which simultaneously brought a new degree of specialisation and distinction between branches of medicine. The aim of this article is to study the impact of new medical knowledge about epilepsy on the treatment and education of children with epilepsy in Sweden. In order to concretise the aim, the study focuses on the asylum Margarethahemmet. The key source material consists of Margarethahemmet’s annual reports and yearbooks. The minutes of the meetings of the Swedish General Association for the Care of the Feebleminded and Epileptic for the period 1915–1938 have been used as supplementary material. In order to trace the impact of medical discoveries on Margarethahemmet’s operations, contemporary scientific articles, mostly from Germany, have also been used. The article demonstrates how new research and new knowledge was sought internationally and nationally, to provide doctors and special teachers at the asylum with a proper knowledge about education, care and treatment for children with epilepsy. The increased understanding of the disease directly impacted the ability of a stigmatized group – people with epileptic disorder – to actively participate in society on the same terms as others.

I would like to thank Professor Ekirch for his reflections on ‘Have we lost sleep?’, which contain several points that I have already responded to within the paper following his peer review of my original submission to Medical History in 2023 (Professor Ekirch having voluntarily identified himself as a reviewer in a normally double-blind process). I acknowledge that the focus of my paper was on Ekirch’s original work from 2001; if I did not engage as he would have wished with his subsequent publications, this was simply because I do not perceive the same substantial developments in his thinking and research on the subject that he does. Indeed, the present critique by Ekirch amounts essentially to more of the same: a long list of references and quotes but little detailed discussion of any individual source. As my paper demonstrates, seemingly unambiguous evidence from a brief quotation can become less clear-cut when placed in context. I am sorry if I deploy the word ‘might’ more than Ekirch would like. This reflects, I hope, a healthy degree of uncertainty and intellectual humility in my approach to the complex issue of pre-industrial sleep. To extend Ekirch’s metaphor, if the jigsaw puzzle that both he and I are trying to assemble can take the form of a cat or a dog, it is possible that its true form is neither animal. The extent to which people woke in the night in pre-industrial Europe, the duration of such awakening, and the predominant cultural attitude towards this—concern, acceptance, or indifference—are topics about which it would seem wise to avoid sweeping statements and generalisations, given the relatively long period covered and the social, cultural, and individual diversity that must be taken into consideration. I can only repeat that I think amassing more brief references, and selectively citing relatively small physiological studies and anthropological evidence from global settings, is unlikely to provide much clarity, let alone definitive answers. I welcome Professor Ekirch’s contribution to this discussion as an indication that the question of segmented sleep in early modern Europe is by no means settled but is a matter of ongoing debate.

The article, ‘Have we lost sleep? A reconsideration of segmented sleep in early modern England’, Medical History, 67, 2 (2023), 91–108, by Niall Boyce is devoted to criticising my historical research pertaining to 1) the predominance of segmented sleep in the pre-industrial Western world and 2) the nineteenth-century transition of sleep to today’s pattern of continuous slumber that most people in modern societies seek to achieve, albeit not always successfully. This response addresses Boyce’s reinterpretation of the evidence and indicates whether this is erroneous or selective. My analysis thereby reasserts the predominance of segmented sleep in pre-modern Western Europe. Boyce’s assessment rests not on his original investigation of primary sources but on my first study relating to segmented sleep, published in 2001. Not least of the flaws of ‘Have We Lost Sleep?’ is its surprising inattention to my subsequent works that have expanded, modified, and bolstered this initial publication.

Medical practitioners, inevitably scattered across the country, need frequent periodicals to communicate the latest medical information. Journals are an essential component of the infrastructure of modern medicine, yet they were slow to achieve firm roots in Britain during the eighteenth century, with few sustained quarterly periodicals and the only attempt at a monthly lasting a year. Then in 1799, Richard Phillips, owner of the Monthly Magazine, published the Medical and Physical Journal, the first sustained monthly medical journal, which lasted for thirty-four years. Ever since, Britain has never been without a monthly or weekly general medical journal. Responding to the need for a strong commercial focus, the Journal used a magazine format which blended reviews and abstracts of already published material with original contributions and medical news, and it quickly achieved a national circulation by close engagement with all types of practitioners across the country.

Contrary to the historiography, the Journal was distinctly different from the contemporaneous monthly science journals. The key to success was two-way communication with all practitioners, especially the numerous surgeons and surgeon-apothecaries who were increasingly better trained and confident of their status. Much of the content of the Journal was written by these readers, and with rapid, reliable distribution and quick publication of correspondence, controversial topics could be bounced back and forth between all practitioners, including the distinguished. Initially, the editors tried to maximise circulation by avoiding any controversy, but this started to change in the first few years of the next century.

Premodern medicine used a variety of mineral substances for therapeutic purposes. The present article deals with pitch-asphalt, and, in particular, a precious kind of it called mūmiyāʾ originating in Persia. It was first described in detail in the Arabic pharmacological tradition, and its fame spread throughout the medieval Mediterranean, including Byzantium. By editing and examining for the first time a previously unexplored medieval Greek text on mūmiyāʾ, this study offers new insights into the medicinal uses of this substance. It also significantly increases our understanding of the intense cross-cultural transfer of medical knowledge from the Islamicate world to Byzantium by showing that this was not merely based on the translation of a few Arabic medical works into Greek, but was a multifaceted phenomenon involving a complex nexus of sources that require further investigation.

This article reconstructs the first outbreak of epidemic dropsy recorded in documentary evidence, which occurred in Calcutta, Mauritius, and northeastern India and Bengal in 1877–80. It uses current medical knowledge and investigations into the wider historical contexts in which the epidemic occurred to re-read the colonial medical literature of the period. It shows that colonial policies and structures in the context of variable enviro-climatic conditions increased the likelihood that an epidemic would break out, while also increasing the vulnerability of certain populations to infection and mortality. Additionally, it shows how the trans-regional nature of the epidemic contributed to varying understandings of the disease between two colonial medical establishments, which influenced each other in contradictory ways. The article’s core contributions are to recent trans-regional perspectives on disease transmission and colonial medical knowledge production in the Indian Ocean World.