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

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.

Pharmacists and pharmacies are key drivers in the American marketplace. They serve as an endpoint of the pharmaceutical supply chain and are the dispensers of a range of consumer goods, some nonthreatening and others potentially harmful to public health. In adding pharmacies to the roster of consumerist locales in the postwar period, scholars might draw even deeper connections about the transformation of health, corporate medicine, and American economic power. To understand the interface of consumerism, corporatism, and health in postwar America, this article holds the postwar pharmacy as a key site of commodity exchange and business and positions it within the larger American firmament, paying attention to the design of pharmacies. In particular, the article will add to the knowledge about the tangible ways that medical and health care spaces are constructed, organized, and designed to best generate profits. Besides prescription medications, alcohol, tobacco, and sugar-rich products were also vital elements of the postwar pharmacy and will be featured in this article. What is more, this article focuses on a central debate between pharmacists during the postwar period about how pharmacies were shifting from the role of healer to that of a retailer - from a "conscientious guardian" to a "commercialized jungle" - in order to highlight how the public health role of pharmacies was undermined by industry pressures for profit. Based on unused corporate guides and manuals, company records, photographs, and management documents, this article will spotlight the underexplored interiority of pharmacies - the store's insides, processes of organization, and design features related to potentially habit-changing substances.

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.