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

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.

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.

In the second half of the twentieth century, concerns about problems in the doctor-patient relationship gave way to a new medical discourse on suffering, owed largely to the work of American physician Eric Cassell. This article tracks the development of his theory of suffering and its global success in transforming tragic medical experiences into diagnosable clinical entities. Beginning with his intellectual development in the 1960s, this article traces Cassell's initial interest in suffering first to his early research on truth-telling and autonomy, followed by his pioneering work in bioethics. Although closely aligned with philosophy, much of the institutional success of bioethics came from American law, which affected Cassell's theorizing. At the same time, doctors experienced a growth in medical malpractice lawsuits, driven in large part by costly "pain and suffering" awards, which the medical community sought to curb by encouraging legislatures to codify informed consent. The success of these efforts mandated that doctors disclose previously withheld bad news capable of causing suffering. The cultural changes that followed these disclosures became Cassell's impetus, while legal pain and suffering supplied much of his theory's language and concepts.