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

The paradox of excess mortality among White Americans during the 1918 influenza pandemic has long puzzled historians and scientists. Recent scholarship has suggested that this disparity was not true for the country as a whole, but rather regional variation was observed. The factors influencing these disparities remain speculative. A case study was conducted of Durham, North Carolina, a city known nationally for the achievements of its Black middle class, to further explore these themes relying on numerous sources including newspapers and death certificates. Though Durham's overall mortality was lower than many places in North Carolina, the White mortality rate greatly exceeded that of the Black population. Previously described theories, including Alfred Crosby's exposure hypothesis and segregation, were explored. The most notable difference between Durham's pandemic narrative and other comparable towns was the robust healthcare response, which was made possible by the excellence of the Black nursing force from Lincoln Hospital. Nursing care was the best treatment available for the 1918 influenza, but most of the nation experienced severe nursing shortages due to the war effort. This study thus provides an example of how the Black health community has proven an active agent in countering the structural forces driving racial disparities.

In 1882, William Osler wrote "Professional Notes among the Indian Tribes about Great Slave Lake, NWT," a fantastical essay that purportedly described the sexual and obstetric customs of Indigenous peoples residing in the Canadian Northwest. Originally prepared as a prank, "Professional Notes," along with Osler's alter ego Egerton Yorrick Davis, became an elaborate inside joke that circulated widely among the medical elite for decades after Osler's death. In this essay, I trace the history and afterlife of "Professional Notes," considering both the colonial context of its creation as well as the reasons for its enduring popularity. I argue that "Professional Notes" both reflected and reinforced the anti-Indigenous racism that permeated the medical profession, particularly during its consolidation in the late nineteenth and early twentieth century. I also make a methodological argument for the study of joking within the history of medicine, presenting "Professional Notes" as a powerful example of the role humour has played in shaping medical culture.

Peptic ulcers were a common, and seemingly intractable, problem for surgeons in the US through the early twentieth century. Initial surgical efforts reduced operative mortality and achieved short term successes but failed to establish a definitive solution. The flawed successes of early ulcer surgery drove sustained effort to improve, producing a stream of novel operations over the decades. An examination of the history of ulcer surgery confirms the recent observation that surgical operations of this period were malleable entities subject to constant tinkering and repurposing. Yet, this dynamism in surgical practice remained in tension with conservative pressures, as surgeons hung on to familiar practices and sought to codify agreement on which operation served best for which purpose. Ulcer surgery became a workshop for attempts to resolve this tension. In this context, a canon of recognized operations emerged that accommodated novelties while preserving in surgical discourse an awareness of older operations. Established operations that fell from use literally remained on the books for decades. This compromise between innovation and operative conservatism favored the creative reuse of older ulcer operations, some repurposed, and some combined with other operations in new modular configurations. Ulcer surgery demonstrated recurring patterns of operative repurposing, reconfiguration, and modular recombination. This feature of twentieth-century ulcer surgery also highlights the attachment in modern surgical culture to the historicity of their endeavor, manifested for example in the wide use of eponyms and a fondness for deep genealogies of mentoring and training.

New medical devices and diagnostic tools dramatically expanded the capabilities of modern medicine in the late twentieth century. Nevertheless, many contemporary commentators argue that American medical devices receive insufficient regulatory scrutiny and often pose significant safety risks. This article probes the foundations of US medical device regulation by analyzing the technoscientific practices of physicians and engineers who designed or regulated medical technologies. Studying this history through the lens of professional power dynamics reveals the medical profession as one of the primary power brokers in device ecosystems. Physicians used their collective status and influence as medical experts to shape the legislation governing medical technology and oppose policies threatening their professional autonomy. Situating conversations about device regulation in the historical and sociological literature on professionalization demonstrates the salience of physicians' professional power in creating the modern regulatory environment.

This article explores the historical uses of two animal medicines that are understood in current biomedicine to have potential endocrine activity: deer musk and whale ambergris, which were prized as aphrodisiacs in the early-modern world. It diverges from the focus in existing scholarship on nineteenth-century gonadal organotherapy as the precursor for the modern discovery of the sex-steroid hormones, looking instead at the older examples of deer musk and whale ambergris that were commonly prescribed both in medieval Islamicate and early-modern European Christianate medical sources. The early-modern Latin, French, German and English description of these substances as fertility, aphrodisiac, and rejuvenative remedies indicates a direct exchange of pharmacological concepts and substances relating to the human sexual and reproductive systems between Europe and the Middle East from the sixteenth to eighteenth centuries. The article explores how musk and ambergris were used in early-modern Western medicine, and how knowledge of them circulated across cultures. I argue that musk and ambergris, which were both thought to have effects on vitality, fertility, and potency in medieval Middle Eastern and early-modern European traditions, trouble the view of the origins of sex-steroid hormone endocrinology as deriving purely from modern European gonadal opotherapy. The valuing of these substances as fertility, vitality, and aphrodisiac remedies in the work of early-modern European physicians was indicative of both the globalization of medical knowledge, and an increased commercial trade in pharmacological material goods, confirming the view of medical globalization as a multi-directional historical process constituted in both conceptual and material terms.

When asked why nearly all doctors refer their breech cases to surgery, despite non-surgical breech birth being permitted throughout the United States, an obstetrician will likely cite the Term Breech Trial (TBT). This study, conducted in 2000, decisively concluded that planned cesarean delivery is safer than vaginal breech delivery. However, a review of the literature suggests that the decline of vaginal breech deliveries was a long time in the making. From the 1950s, once the perceived risks of breech births were accepted as a fact, numerous studies advocated more liberal use of cesarean delivery for breech babies and suggested strategies to limit vaginal breech births. By the late 1970s, as the majority of breech patients underwent surgery, a vicious cycle of collective forgetting began. Hospitals and medical training programs abandoned the non-surgical option, leaving younger generations of unskilled doctors reluctant to perform the complex procedure. As health organizations criticized the overuse of cesarean sections in the ensuing decades, obstetricians faced a growing dilemma in breech management, continuing to perform surgeries even while questioning their benefits. The 2000 study sanctioned this existing state of practice, which had been evolving over decades and in which collective forgetting played a crucial part.

From the 1830s onward, Euro-American medicine began addressing opium addiction among the Chinese population. Drawing upon records from medical missionaries, medical journals, and related Chinese sources, this article examines the transformation of opium addiction treatment in late Qing China (1830-1910). Despite their pioneering efforts, medical missionaries encountered various challenges in gaining cooperation from patients and Chinese authorities. In contrast, Chinese medical practitioners, particularly elite scholar-physicians, enjoyed favor with the Qing government throughout much of the nineteenth century. By the turn of the twentieth century, the scientific knowledge introduced by the missionaries had gained greater acceptance in the country. By creatively translating this knowledge, Chinese medical practitioners began to recognize new theories for addressing the opium problem.

This paper provides a case study of one medical experiment conducted in 1915 by the United States Public Health Service in collaboration with the Mississippi State Penitentiary. The experiment was non-therapeutic and its objective was to induce pellagra (a vitamin deficiency disease) in twelve healthy White male prisoners to confirm its etiology. Extant archival records produced by the convict participants, state politicians, and health researchers underscore that the men selected for the pellagra experiment were unique among incarcerated people in Mississippi at the time: they were White, wealthy, and politically well-connected. This paper contends that the convict participants leveraged a wide range of social and political connections to secure their participation in the pellagra experiment as an expeditious pathway to pre-arranged executive pardon, a phenomenon that I term medical clemency. By situating the 1915 pellagra prison experiment amid the broader landscape of incarceration, public health research, and systems of political patronage in Mississippi, this paper highlights the ways in which penal systems are embedded in broader social and political contexts. Not only did the experiment exacerbate pre-existing social inequalities behind bars, it also had lasting consequences for those involved in prison medical research - namely, the power to determine which kinds of convicts could ultimately re-enter the social order.

While most are aware of the Tuskegee syphilis experiments in which African American syphilis patients went untreated, less is known about experiments with malaria fever therapy conducted upon syphilis patients during the same period by the Unites States Public Health Service at the Williams Laboratory on the grounds of the South Carolina State Hospital (SCSH) in Columbia, SC. Over a twenty-year period, physicians maintained patients as malaria reservoirs for patient-to-patient inoculation and subjected patients to extreme fevers and thousands upon thousands of insect bites as part of a program in which one disease was tested as therapy for another. Using extant administrative files, medical journals from the period, and a database created from SCSH annual reports, this paper considers the ethics of malaria fever therapy experiments while exposing the conditions under which patients suffered the intersecting oppressions of race, class, and mental illness. It illuminates the prevalent scientific racism of the period that enabled pseudo-medical assumptions about African Americans' perceived penchant for poverty, deviant sex, and pain tolerance, which combined to enable a culture of experimentation that influenced events at Stateville Penitentiary and continued long after penicillin became widely available.

This essay uses the unpublished casebook kept by the Tuscan surgeon Giovanbattista Nardi to examine the provision of urgent medical care in sixteenth-century Italian hospitals. Most major hospitals on the peninsula maintained separate therapeutic spaces known as medicherie for this purpose. Written in the 1580s while Nardi worked as a staff surgeon at a Florentine civic hospital, this rare surgical casebook provides insight into the types of institutional resources devoted to acute medical problems; the clientele seeking immediate assistance and the situations that brought them there; the treatments used to achieve short-term "cures"; and the clinical experiences of hospital surgeons who served as frontline healers. A close analysis of the seventy-nine cases recorded sheds new light on everyday surgical treatments for conditions ranging from serious head injuries requiring trephination to syphilitic lesions and genital trauma. Casebook entries also reveal Nardi's deep engagement with the composition and use of topical remedies as both practitioner and experimenter. Intended as a memory aid for future reference, the casebook shows material traces of the author's shifting occupational identity as he matured from hospital surgeon to university-trained physician. Viewed through multiple lenses, this richly layered source expands our understanding of both the practice and profession of early modern surgery.