Medical History最新文献

The Pinel Sanatorium, the brainchild of Doctor Antonio Carlos Pacheco e Silva, a leading figure in Brazilian psychiatry, was inaugurated in 1929 in São Paulo as a private institution. It operated until 1944, during which time it recorded approximately 4,500 hospitalisations. In 30 psychiatric records, in addition to the usual clinical records, such as the Psychiatric Examination - in which the doctor records the elements he deems essential for identifying the mental illness from different sources of information, such as those provided by family members - attachments were found containing letters and short texts written by the inpatients. Addressed to different people, these letters, which were retained and evaluated by the doctors, played a central role in assessing the psychiatric conditions of the inmates. However, by being considered historical sources that reveal the 'point of view' of the mad, these documents are fundamental to the development of innovative approaches in the field of the history of madness and psychiatry. Based on the articulation between the context in which these records were produced, the social markers of difference that constitute the subjects, as well as the emotions expressed by the people who wrote them, the article sets out to answer two questions: (1) How the emotions expressed - both by the inmates and by their loved ones - were interpreted by psychiatrists and used to formulate diagnoses, and to define treatments and prognoses; (2) What meanings these emotions took on for the inmates themselves, in other words, how they put their experiences and subjectivities on display.

HIV/AIDS posed a significant health threat in Denmark from the early 1980s until the end of the 1990s, claiming approximately 2,000 lives. Gay men, hemophiliacs, drug users, sex workers and migrants were overwhelmingly among the victims of the disease. They also constituted the groups most associated with it. This led to a raised level of public attention to these groups; a heightened visibility that ambiguously resulted both in improving the life conditions of some while also increasing the stigma of others. This article analyses the roles of different cross-sector actors in shaping the responses to HIV/AIDS in Denmark, with each group influencing and being influenced by the epidemic. Yet despite the clear connection between HIV/AIDS and the minoritized, often marginalized, groups, the article argues that the overarching and dominant response objective during the crisis in Denmark was to prevent a heterosexual epidemic. Throughout the crisis, other responses, aims and objectives concerning the groups most affected by HIV/AIDS could be, and did become, contingent with this dominant objective. The strengths and positions of those subresponses depended on, however, the perceptions of them as logical and tangible means to the primary end of preventing the heterosexual epidemic. Pulling together different and changing responses from different and changing actors serves to crystallize what objectives or logics are the mutual ones, and the significance of this analysis is that what appeared to be a very heterogeneous set of responses to the disease in Denmark, was in fact rooted in the same objective. Notably, the perceived pertinence of preventing the heterosexual epidemic was not rooted in actual rates of infection or spread of the disease.

The U.S. National Library of Medicine holds two collections by Adolf Nichtenhauser (1903-53) that have become important sources for historians of medical and health films: an unpublished book-manuscript in which he surveys the history of medical and health films to around 1950, primarily in Europe and North America; and the valuable collection of documents he amassed partly during his research for this book-manuscript. Such is the richness of these collections that it is difficult to imagine a history of medical and health film that is not in some way indebted to Nichtenhauser. Indeed, his book-manuscript has become a standard citation in the historiography of medicine, health and film. Yet very little is known about Nichtenhauser himself, other than that he was a European immigrant to the United States who wrote this key history and died before its completion. This article seeks to do three things: to provide the first English-language biography of Nichtenhauser from his early life in Austria to his career in the United States; to use this biography to explain how he came to write this book-manuscript; and to explore the relationship between his historiography and efforts in the 1940s and 1950s to identify and solve problems with application of film to medicine and health.

Throughout the twentieth century, senior roles in UK public health were reserved for doctors. Local authority medical officers of health were replaced in 1974 by NHS community physicians and from 1989 by medical directors of public health. Over the last decade of the century, an increasingly vocal group of non-medical public health professionals sought to break the glass ceiling that restricted them from advancing to senior roles; although they received encouragement from some leaders within the Faculty of Public Health Medicine, there was also significant resistance from many members. A number of factors came together around the year 2000, which culminated in a ground-breaking decision by the English Department of Health to allow non-medical appointments as directors of public health and consultants in public health in the NHS, with the then Secretary of State memorably declaring it was time to 'take public health out of the ghetto'. At the same time, the leadership of the Faculty of Public Health Medicine overcame opposition from some of its members and opened its training, examinations, and membership to non-medical candidates. By the early 2020s, half of the renamed Faculty of Public Health members were from backgrounds other than medicine as well as 90% of directors of public health in England. This paper explores the complex history behind this unprecedented opening of a medical specialty to non-medical membership, the factors that enabled it, and the continuing legacy of tensions and inequalities within an occupation that is both a medical specialty and a multidisciplinary profession.

The inter-war period was a time of mobilisation against syphilis in France and its colonial empire. The spread of the disease was perceived as a threat to the economic development of its colonies, particularly because of the labour shortages it might cause. In 1916, a new player appeared on the scene of the French efforts to control the disease: the Institut Prophylactique, founded by Arthur Vernes. Its project was nothing less than to eradicate the disease, and its activities in the colonies expanded significantly during the 1920s and 1930s. However, the Institut Prophylactique has been largely forgotten in the history of medicine. Although the project was a failure, this article shows that it played an important role in controlling syphilis, both in France and in its colonies. This historical study thus emphasises the importance of considering alternative and failed projects as part of the complex picture of health history.

This article explores how psychiatrists conceptualised the role of family relations and emotional atmospheres in the context of schizophrenia research in the second half of the twentieth century. It traces how families became the primary site to be mined and measured to explain schizophrenia's onset, course and outcome, and zooms in on global psychiatric investigations of expressed emotion in families of schizophrenic patients, which aimed to offer a theoretical framework for understanding one of the most intriguing and influential findings of transcultural psychiatry: that schizophrenia appeared to have a shorter course and favourable recovery rates outside the Western world. The article engages with a wealth of research materials from schizophrenia and expressed emotion studies, and a variety of voices - clinicians, patients, families - which shaped these investigations. It also draws a comparison between this discussion of 'traditional' families as a beneficial environment for schizophrenia, and critical psychiatric and psychoanalytic discourses from the middle decades of the century which focused on the reportedly extreme psychopathological potential of 'schizophrenogenic' family relations in the Western world. Analyzed through this prism, expressed emotion research constructed the Global South as a preferable, even romanticized, alternative to the Western model of family interaction. On closer inspection, however, this idealization of the traditional family involved a variety of essentializing and romanticizing ideas which reinforced the ever-present binary of the modern West versus backward Global South, and perpetuated the belief in the decolonising and developing world's cultural and intellectual simplicity.

This article is an attempt to reconstruct the history of the first Nigerien psychiatric service, and diverse aspects of the ordinary functioning of Pavillon E in Niamey (Niger): the organisation of daily life, the position occupied by coopérant doctors, the precise perimeter and development of practices taken from social and community psychiatry, and relationships with the outside world (families, police, legal system, the public health office).This research allows us to rehistoricise and refine the details of a period from 1950 to 1980 which, up until now, was viewed as fixed and anachronistic. We draw on precious sources of empirical data - medical and administrative archives, students' dissertations, oral sources - which invite us to reconsider both colonial/post-colonial (dis)continuities and the temporal caesuras in the literature or in reports from the time.This landscape of mental healthcare appears to be more or less deeply affected by regional and international dynamics, such as the French coopération system, the networks of ethnopsychiatry and transcultural psychiatry, or the network of pharmaceutical groups and their subsidiaries.Studying this service also raises the issues of the chronology and daily life of post-independence psychiatric care in francophone West Africa. Finally, our research interrogates the intellectual partitions between reforming disalienist movements and day-to-day psychiatry, and addresses fundamental epistemological questions on how historiography can restore the balance of knowledge between them.

In this article, I examine the history of the concept of herd immunity, beginning with British epidemiologists in the 1920s and ending with the controversy surrounding it during the COVID-19 pandemic. I argue that competing historical and contemporary understandings of herd immunity reveal an underlying tension between observing the effects of infection-acquired herd immunity on the population dynamics of infectious diseases and actively cultivating it through immunisation. Originally offering an explanatory mechanism for the rise and fall of epidemics, the concept soon became entangled with strategies of disease control and technologies for producing immunity, particularly as mass vaccination became more common in the postwar era. This tension between observing herd immunity and cultivating it has produced diverse interpretations ranging from the temporary abatement of an outbreak due to the accumulation of infection-acquired immunity to the principle undergirding disease elimination through mass vaccination. I close by suggesting that the scientific debates and uncertainties regarding the relevance of herd immunity to public health strategies during the COVID-19 pandemic reflect this long-running tension between observing and cultivating immunity in populations.

The best known historical narrative of the international mental hygiene movement among English-speaking audiences locates its origins in the publication of A Mind That Found Itself, the autobiographical account of Clifford Beers (1876-1943), a Yale graduate and former psychiatric patient. The success of the book is thought to have prompted the creation of the first Society for Mental Hygiene in Connecticut in 1908. Beers' biography, published as Advocate for the Insane in 1980, contends that mental hygiene abroad developed from seeds first sown in the USA and subsequently in Canada.This article offers a critical reappraisal of that narrative and advances an alternative framework for understanding the history of the international mental hygiene movement during the first half of the twentieth century. It draws on a body of scholarship, emerging since the 1980s, that has sought to decentre the prevailing account, exposing the multiplicity of forces at work in a history that diverges from any straightforward, linear trajectory radiating from a single point of origin.By tracing this decentred history, the article highlights the contested nature of the 'international' in the context of the mental hygiene movement. Case studies from the USA, France, Brazil, and Argentina reveal both the conflicts it engendered and the diverse meanings and significance it assumed within distinct national settings.