Journal of the History of Medicine and Allied Sciences最新文献

In the standard story of the rise of professional authority in medicine in the 1920s, state medical licensing boards were partners in a coalition, led by the American Medical Association, to radically improve medical education. Boards obtained state laws that limited admission to licensing examinations to graduates of schools approved by the AMA, thus bringing about the rapid demise of low-quality schools by about 1925. The reality at the state level was quite different, however. Medical examining boards containing homeopaths, eclectics, and sometimes osteopaths could be far from reliable partners. Passing laws to benefit the medical profession was exceedingly difficult and dependent on local medical politics. Through the lens of a major medical diploma mill scandal revealed by a journalist in 1923, this paper examines reform efforts in three states greatly affected by the scandal: Missouri, where the scandal originated, Connecticut, and Massachusetts. In each of these states, graduates of low-quality schools as well as fake doctors from diploma mills were able to take a state examination and practice. This paper argues that the AMA, far from being the major player in the elimination of inadequate schools, could set standards but had to stay on the sidelines.

Post-Emancipation medical and social science scholars extensively theorized Black susceptibility to illness, disease, and death. Most studies of late nineteenth-century medical ideas about the relationship between race and disease have highlighted the construction of medical beliefs that associated Black physical weakness with a proclivity to ill health. This study presents an alternate narrative, one where certain diseases - asthma and hay fever - reflected an opposing racialized understanding of disease that instead centered on White frailty. Based on an examination of turn-of-the-century asthma and hay fever medical literature produced by George Miller Beard, the professionalization of the United States Hay Fever Association, and the publication and dismissal of the first recorded case of asthma in an African American man in 1884, this article argues that late nineteenth-century asthma and hay fever physicians, who themselves often suffered from the conditions, defined the typical asthma patient along racial lines to protect the exclusivity of their own professional and social identities. As a result, asthma and hay fever in Black communities, particularly in the North, where asthma and hay fever scholars primarily lived and worked, remained obscured and untreated until the mid-twentieth century.

In a profession shaped by Whiteness and masculinity, the few Black women physicians who earned medical degrees prior to the Second World War found some of their rare professional opportunities in public health. Though their choices were often constrained by racism and sexism, they embraced public health work as a means of carrying out their "mission" in marginalized communities and as a way of practicing medicine with a more expansive definition than treating individual patients or illnesses. Black women physicians shaped public health by creating unique programming to meet the needs of the communities they served, including mobile health clinics and community health weeks. The first Black women physicians who worked in public health in the nineteenth and early twentieth centuries applied the new tool of public health "vital" statistics to Black lives and questioned the limits of their utility when created by White practitioners with racial biases. In the 1930s, some Black women physicians began earning some of the first master's degrees in public health, just as the field was beginning to professionalize. Throughout the twentieth century, Black women physicians pioneered community health programming and, though born from exclusionary policies that limited where they could practice, experimented with alternative clinical spaces, even as the hospital and laboratory became the primary sites of medicine for White clinicians. By embracing public health, Black women physicians shaped the field and used it as a tool to address racial health disparities in the communities they served, acting on their belief that Black health could be improved, thereby contesting notions of biological inferiority.

This paper offers a historical analysis of the American plastic surgeon and Nobel laureate Joseph E. Murray's kidney transplantation. After succeeding in the first kidney transplantation between monozygotic twins in 1954, he transplanted kidneys between genetically distinct people after X-radiation and immunosuppressants. Amid these achievements, however, Murray encountered numerous failures, which he thought were closely intertwined with each patient's physiological and pathological individuality. As he appropriated his expertise in plastic surgery for kidney transplantation, this individuality became a major issue that he had to cope with in his efforts to avoid failures. To him, kidney transplantation could fail because of each individual's immunological barrier or constitutional singularity that could engender unexpected complications. Although he could neither explain nor control many of these failures, I argue that his unsuccessful work and patient individuality played multiple roles in shaping his operations as a plastic surgeon. They structured the path of his surgical research, made sense of it, defended him from criticism, and formed the way that he presented the results of his work with an immunological implication. Consequently, Murray, with little scientific training, articulated an important dimension of immunological tolerance relevant to clinical settings.

In September 1975, Frank Moss, an eighteen-year veteran of the Senate from Utah, donned the scruffiest clothes he could find and walked into a small clinic in New York that catered to Medicaid patients. Using a phony Medicaid card supplied to him by a New York District Attorney, he posed as a patient with symptoms he feigned to assess the quality of care he would receive. Appalled by what he experienced, he and a team of staffers from his office embarked on a four-state tour of what he termed "Medicaid mills," visiting more than 200 clinics in an undercover investigation that exposed alarming levels of provider fraud and abuse of the government health insurance system. This dramatic expose was covered by CBS's widely watched Sunday-night news program 60 Minutes. The subsequent Senate hearings were a media sensation, leading to accusations that the Senator was "grandstanding." This article looks at the political climate in which the congressional sting operation, the media attention it garnered, and the subsequent legislation enacted sought to address a persistent, growing problem of fraud and abuse in Medicare and Medicaid. The article argues that Moss's effort was an example of entrepreneurial politics, as defined by Craig Volden and Alan Wiseman in 2016, and something more as well. Moss was reacting to a political setting in which the legitimate authority of political institutions, including Congress, had been called into question by the Watergate scandal and other revelations. At the same time, organized medicine in America was dealing with its own version of this challenge to its authority. The result was a dramatic episode that focused on fraud and abuse in the ten-year-old Medicare program and that raised wider questions about changes in cultural authority in politics and medicine.

The numerous votive uteri found across the central Italian peninsula from the fourth to first centuries BCE are puzzlingly evocative of the human simplex uterus, which is visually distinct from the bicornuate uteri characteristic of most other mammals. However, human dissection is not attested for this time and place, while animal butchery was common. This article uses modern veterinary anatomical imagery to argue that animal uteri - specifically as they appear when pregnant - were indeed models underlying the votive depictions. Some of the variant forms of the votives are highly evocative of various features of the pregnant bicornuate uterus. Further, medical views on the human uterus throughout classical antiquity were informed by animal uteri. Taken together, the visual and textual evidence indicate that animal models were inextricably integrated into ancient conceptions of the human uterus across the classical world, including in the production of the Italic votives in question.

This article provides a comparative analysis of the treatment of disabled First World War veterans in 1920s Britain and the simultaneous care of Imperial Pensioners residing in Australia and South Africa via the detailed administrative reports of a British civil servant, G.F. Gilbert. Imperial Pensioners were disabled veteran migrants of the British Army residing overseas. A study of these veteran populations in Australia and South Africa provides two primary insights into the broader historiography of disabled veterans. Firstly, a comparative case study helps to show the way in which cultural notions of disability were part of broader ideas of nation-building overseas. Secondly, the specific disability diagnosis category chosen as a more in-depth case study can further complicate and contradict broader assessments of national responses. This article attempts to build upon recent transnational histories of veterans by transcending national boundaries and homogenous veteran profiles with an extension in methodological scope by providing an intra-national case study via the Imperial Pensioner.