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

In 1867, controversy erupted when Jean-Anne-Henri Depaul, a Paris accoucheur, tested Justus von Liebig's new "food for infants" on four newborns, all of whom died within days. This paper examines the origins of Liebig's food, the debates in the French Academy of Medicine after Depaul's experiment, and how the events were discussed in the medical and popular presses. I argue that the controversy was shaped by a number of interconnected concerns, including the product's impracticality, disagreements within the field of chemistry, the riskiness of Depaul's experimentation, Liebig's problematic celebrity, the potential hubris of trying to emulate a natural product, and national tensions between France and Germany. Infant feeding was an emotionally charged and highly politicized site where multiple interests, anxieties, and ways of knowing collided. Although commercial infant foods, many of which made reference to Liebig in their advertising, would ultimately find popularity in the last decades of the nineteenth century, close attention to the first years of Liebig's product demonstrates that its credibility as a "scientific" mode of infant feeding was far from assured. Rather, Liebig's milk illustrates the early challenges of constructing and enforcing knowledge and trust at the intersection between food, science, and infant life, in both professional and popular arenas.

When in the late nineteenth century American physicians increasingly replaced midwives in the care of obstetrical and gynecological patients, they could do so only because they were aided by another emerging group of healthcare professionals: nurses. Nurses were instrumental in assisting physicians in the care of patients in labor and during recovery. They were also necessary for male physicians because the vast majority of nurses were women and their presence during gynecological and obstetrical treatments made it more socially acceptable for men to examine female patients. In hospital schools in the northeast and through long-distance nursing programs, physicians taught students about obstetrical nursing and instructed them to protect the modesty of female patients. They also tried to instill strict professional hierarchies between nurses and physicians, emphasizing that nurses should never attempt to deliver a patient without a physician. But as nursing emerged into a unique professional practice separate from that of physicians, nurses were able to negotiate better education in the care of laboring patients. In order to take over women's sexual and reproductive health care from traditional providers, physicians conceded to nurses' demands for more authority in patient care.

The Declaration of Alma-Ata remains one of the momentous documents of public health. Its origins lie both in postwar efforts to improve population health in low-income countries and in social medicine promoted decades earlier in Europe. For industrialized countries in East and West, Alma-Ata, therefore, should have provided health-related guidelines both for domestic and foreign policy, though political interpretations of the social components of medicine and health differed. Due to its unique history of ideologically informed division after 1945, Germany forms a fascinating case study. Important German contributions to the early social medicine discourse fed into ideas of primary health care, the basis of the Alma-Ata process. However, the concept found little resonance in domestic policies. After World War II, the two Germanys chose different paths for health systems but were similarly reluctant to address the social dimension of health in their cooperation with Africa, Asia, and Latin America. In the 1970s, new international health concepts and civil society discussions about "development aid" caused changes in West German policies. No such discussions took place in the German Democratic Republic (GDR), where Alma-Ata was interpreted as a confirmation of the domestic health system. Thus, ironically, West German health workers pursued a keener policy of principles of social medicine in their partner countries than the GDR government, which considered its role in the global transformation of health care mainly fulfilled by serving as a model.

In the early- to mid-nineteenth century, European mortality rates in West Africa were the highest in the world. Mortality estimates included nine missionaries sent from the Basel Mission (established in what is now Switzerland) to the Gold Coast (present-day Ghana), eight of whom died between 1828 and 1840, mostly from "fevers." In response to high mortality rates, the Basel Mission recruited several Afro-West Indians to work as Christian missionaries in the Gold Coast, mostly based on the presumption that individuals of African descent would better survive the environment. The decision to recruit Afro-West Indians to evangelize on the Gold Coast seemed to the mission to be a rational decision, one not in need of further justification or an overarching theory of race, environment, and disease. Surprisingly, the Basel Mission did not justify this position Biblically either. Once arrived, the West Indian Christian missionaries mostly lived in the Akwapem hills above Accra at an elevation that would have provided some protection against malaria; subsequently, their mortality rates were significantly lower than the European missionaries. After quinine came to be used as a prophylactic against malaria after 1850, thus lowering European missionary mortality rates, no more Afro-West Indians were recruited by the Basel Mission.

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.

Modern scholarship on the early modern European anatomy theater has long argued that public dissections were theatrical, carnivalesque affairs characterized by viewers' fascination with the material exposure of the dissected body. This essay builds from the recent work on early modern public dissections to argue against such monolithic presentations of the early modern anatomy. To this end, the essay examines three principal source materials connected with public dissections in early modern London to more specifically argue that public dissections in sixteenth- and seventeenth-century London were solemn events focused on promoting the status of London's barber-surgeons' guild, the Royal College of Physicians, and the education and knowledge of their respective members. In this regard, the essay further suggests that there was no single, dominant perception of dissection and anatomy at the time, but that dissection was utilized as a tool for different individual, occupational, and institutional purposes.