During the 1940s, in Britain, there was great activity in the field of social medicine. This was generated by an upsurge in interest in social issues and a desire to promote occupational health research. In 1948 the Medical Research Council established a Social Medicine Research Unit. The background to the creation of the Unit and its early work are discussed. By the early 1950s, the political atmosphere had changed and criticisms of the Unit's work during the debate about continued funding in 1952 are considered. Important work on the relationship between coronary heart disease and physical exercise, and the results of a study of infant mortality, were published in the mid-1950s. A brief account of the subsequent history of the Unit, until its closure in 1975, is given.
{"title":"The early days of the MRC Social Medicine Research Unit.","authors":"Shaun Murphy","doi":"10.1093/SHM/12.3.389","DOIUrl":"https://doi.org/10.1093/SHM/12.3.389","url":null,"abstract":"During the 1940s, in Britain, there was great activity in the field of social medicine. This was generated by an upsurge in interest in social issues and a desire to promote occupational health research. In 1948 the Medical Research Council established a Social Medicine Research Unit. The background to the creation of the Unit and its early work are discussed. By the early 1950s, the political atmosphere had changed and criticisms of the Unit's work during the debate about continued funding in 1952 are considered. Important work on the relationship between coronary heart disease and physical exercise, and the results of a study of infant mortality, were published in the mid-1950s. A brief account of the subsequent history of the Unit, until its closure in 1975, is given.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90994414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This examination of milk safety before the Second World War focuses on the manner in which government regulation was shaped by the agricultural lobby, acting through the Ministry of Agriculture. Dairy farmers used their market strength to resist the introduction of many regulations which were regarded as desirable and even essential from a public health perspective. These included compulsory pasteurization, favoured by the Ministry of Health and the BMA, but successfully resisted by farmers in the 1930s on commercial grounds and so not actually realized until 1949. This episode crystallized the three related conflicts of interest--between rural and urban areas, the needs of agriculture and public health, and the Ministries of Agriculture and Health--which restricted the expansion of state regulation, ensuring that milk still remained a potentially hazardous and occasionally lethal commodity in the late 1930s.
{"title":"State regulation and the hazards of milk, 1900-1939.","authors":"Jim Phillips, Michael French","doi":"10.1093/SHM/12.3.371","DOIUrl":"https://doi.org/10.1093/SHM/12.3.371","url":null,"abstract":"This examination of milk safety before the Second World War focuses on the manner in which government regulation was shaped by the agricultural lobby, acting through the Ministry of Agriculture. Dairy farmers used their market strength to resist the introduction of many regulations which were regarded as desirable and even essential from a public health perspective. These included compulsory pasteurization, favoured by the Ministry of Health and the BMA, but successfully resisted by farmers in the 1930s on commercial grounds and so not actually realized until 1949. This episode crystallized the three related conflicts of interest--between rural and urban areas, the needs of agriculture and public health, and the Ministries of Agriculture and Health--which restricted the expansion of state regulation, ensuring that milk still remained a potentially hazardous and occasionally lethal commodity in the late 1930s.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82648770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An important element in recent science studies has been the analysis of the social rhetoric involved in the construction of disciplines and knowledge. An explicit use of rhetorical and semiotic frames of reference would illuminate many aspects of the history of medicine and could provide a unifying framework for the field. Medical theories were always intended for use and therefore had to be plausible in the eyes of patients. The interpretation of signs and the construction of explanations lie at the heart of diagnosis, therapy and prognosis. These are usually interactive processes and the efficacy of medical interventions therefore depends upon meaning, narrative and persuasion. Since mental processes are not rigidly separated from bodily functions, trust and expectation have physiological effects that are required for successful healing in all cultures at all times. The conduct of patients and practitioners always turns on the expectation of cure and the establishment of confidence. The efficacy of rhetoric was more readily recognized by practitioners in the past than it has been by social historians of medicine. Once mind-body dualism has been discarded, it can be seen that historians are not studying the context of healing but its very heart.
{"title":"Rhetoric and the social construction of sickness and healing.","authors":"David Harley","doi":"10.1093/SHM/12.3.407","DOIUrl":"https://doi.org/10.1093/SHM/12.3.407","url":null,"abstract":"An important element in recent science studies has been the analysis of the social rhetoric involved in the construction of disciplines and knowledge. An explicit use of rhetorical and semiotic frames of reference would illuminate many aspects of the history of medicine and could provide a unifying framework for the field. Medical theories were always intended for use and therefore had to be plausible in the eyes of patients. The interpretation of signs and the construction of explanations lie at the heart of diagnosis, therapy and prognosis. These are usually interactive processes and the efficacy of medical interventions therefore depends upon meaning, narrative and persuasion. Since mental processes are not rigidly separated from bodily functions, trust and expectation have physiological effects that are required for successful healing in all cultures at all times. The conduct of patients and practitioners always turns on the expectation of cure and the establishment of confidence. The efficacy of rhetoric was more readily recognized by practitioners in the past than it has been by social historians of medicine. Once mind-body dualism has been discarded, it can be seen that historians are not studying the context of healing but its very heart.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90942961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making sense of technologies in medicine.","authors":"Jennifer Stanton","doi":"10.1093/SHM/12.3.437","DOIUrl":"https://doi.org/10.1093/SHM/12.3.437","url":null,"abstract":"","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76479541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Educational and therapeutic optimism with respect to those with learning disabilities led to new developments in some countries around the mid-nineteenth century. In the Netherlands there was little specialist care and few special initiatives were taken before the end of the century. The dominant expert opinion was that these people required the standard care offered by the asylum. Two mid-nineteenth-century initiatives, however, are worth analysing, since they signal the cautious start of special institutional education in the Netherlands: the Idiotenschool (School for Idiots) in The Hague and the class for idiots at the Meerenberg Asylum. However, the most important alternative to care in the asylum was offered by institutions with explicitly religious motives, which evolved from Catholic charity and Protestant philanthropy for many different types of socially weak and dependent groups. This article will examine the nineteenth-century religious roots of the care of people with learning disabilities in the Netherlands; it will also show how older educational ideas began to reappear in this context by the end of the century.
{"title":"Christianization of the soul: religious traditions in the care of people with learning disabilities in the Netherlands in the nineteenth century.","authors":"I. Weijers, E. Tonkens","doi":"10.1093/SHM/12.3.351","DOIUrl":"https://doi.org/10.1093/SHM/12.3.351","url":null,"abstract":"Educational and therapeutic optimism with respect to those with learning disabilities led to new developments in some countries around the mid-nineteenth century. In the Netherlands there was little specialist care and few special initiatives were taken before the end of the century. The dominant expert opinion was that these people required the standard care offered by the asylum. Two mid-nineteenth-century initiatives, however, are worth analysing, since they signal the cautious start of special institutional education in the Netherlands: the Idiotenschool (School for Idiots) in The Hague and the class for idiots at the Meerenberg Asylum. However, the most important alternative to care in the asylum was offered by institutions with explicitly religious motives, which evolved from Catholic charity and Protestant philanthropy for many different types of socially weak and dependent groups. This article will examine the nineteenth-century religious roots of the care of people with learning disabilities in the Netherlands; it will also show how older educational ideas began to reappear in this context by the end of the century.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84451997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper confronts a major problem in relation to the metropolitan and urban mortality declines in Britain during the later nineteenth century: the extent to which cause-specific death rates at district level were distorted by an official failure to redistribute deaths occurring in institutions back to "normal" place of residence. Describing and analysing the manner in which hospital and infirmary provision in the capital during this period determined the geographical incidence of mortality, the article develops methodologies that bring the researcher progressively closer to more accurate spatial facts of demographic and epidemiological experience. Devoting separate sections to general voluntary and fever hospitals as well as to institutions administered by the Metropolitan Asylums Board, the paper also engages with similar problems in relation to workhouses and Poor Law infirmaries. By way of conclusion, it shows that, far from generating demographically trivial results, the process of redistribution radically revises the epidemiological history of London in the crucial years between the 1860s and the mid-1880s and provides a dataset that will allow controlled interrogation of the metropolitan mortality decline during this period.
{"title":"Patient pathways: solving the problem of institutional mortality in London during the later nineteenth century.","authors":"G. Mooney, B. Luckin, A. Tanner","doi":"10.1093/SHM/12.2.227","DOIUrl":"https://doi.org/10.1093/SHM/12.2.227","url":null,"abstract":"This paper confronts a major problem in relation to the metropolitan and urban mortality declines in Britain during the later nineteenth century: the extent to which cause-specific death rates at district level were distorted by an official failure to redistribute deaths occurring in institutions back to \"normal\" place of residence. Describing and analysing the manner in which hospital and infirmary provision in the capital during this period determined the geographical incidence of mortality, the article develops methodologies that bring the researcher progressively closer to more accurate spatial facts of demographic and epidemiological experience. Devoting separate sections to general voluntary and fever hospitals as well as to institutions administered by the Metropolitan Asylums Board, the paper also engages with similar problems in relation to workhouses and Poor Law infirmaries. By way of conclusion, it shows that, far from generating demographically trivial results, the process of redistribution radically revises the epidemiological history of London in the crucial years between the 1860s and the mid-1880s and provides a dataset that will allow controlled interrogation of the metropolitan mortality decline during this period.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87081408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The paper concerns the construction of gender norms in popular hygienic literature at the turn of the century. It argues that the formulation of aesthetic gender norms for women's and men's bodies was a response to social developments which were perceived as a threat to the middle-class ideology of separate spheres for the sexes. Concerns about the blurring of gender distinctions were expressed in the aesthetic idiom of the educated middle class. Aesthetic norms for each sex were established and contrasted with the degenerate body forms of contemporaries. The spectre of masculinized women and feminized men was raised, reflecting a deep-seated uneasiness about changing gender roles and identities. The increasing assertiveness of women as expressed in feminist activism was interpreted by anti-feminist authors as a sign of degeneracy. For these authors any articulation of self-interest by women was suspect. Strong sexual desires of women which could serve as the basis for the independent articulation of female sexual interests were denied or declared as abnormal. Feminist critics argued that it was the lack of economic and social independence of women which was the reason for the declining health and beauty of the female sex.
{"title":"Gender and aesthetic norms in popular hygienic culture in Germany from 1900 to 1914.","authors":"M. Hau","doi":"10.1093/SHM/12.2.271","DOIUrl":"https://doi.org/10.1093/SHM/12.2.271","url":null,"abstract":"The paper concerns the construction of gender norms in popular hygienic literature at the turn of the century. It argues that the formulation of aesthetic gender norms for women's and men's bodies was a response to social developments which were perceived as a threat to the middle-class ideology of separate spheres for the sexes. Concerns about the blurring of gender distinctions were expressed in the aesthetic idiom of the educated middle class. Aesthetic norms for each sex were established and contrasted with the degenerate body forms of contemporaries. The spectre of masculinized women and feminized men was raised, reflecting a deep-seated uneasiness about changing gender roles and identities. The increasing assertiveness of women as expressed in feminist activism was interpreted by anti-feminist authors as a sign of degeneracy. For these authors any articulation of self-interest by women was suspect. Strong sexual desires of women which could serve as the basis for the independent articulation of female sexual interests were denied or declared as abnormal. Feminist critics argued that it was the lack of economic and social independence of women which was the reason for the declining health and beauty of the female sex.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83431152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public health concern with food safety and food poisoning emerged in Britain in the 1880s following the first indication that acute gastric illness was caused by a specific organism. Although incidents were for many years only sparsely reported, the central medical department and its scientists were anxious to extend their knowledge of the incidence, specific causal organisms, and epidemiology of the illness. This paper argues for a widespread incidence of food poisoning in Britain in the nineteenth century and traces the social economic, and hygienic contexts within which it occurred. As deadlier infections retreated, food poisoning became an increasing concern of local and national health authorities, who sought both to raise public awareness of the condition as illness, and to regulate and improve food handling practices. Notification of cases was begun in 1939, and this, together with social changes during and after the Second World War, produced an escalating spiral of reported incidents which still continues. This trend, it is argued, is essentially an artefact, whose significance is reduced if considered in its broader historical context.
{"title":"Food, hygiene, and the laboratory. A short history of food poisoning in Britain, circa 1850-1950.","authors":"A. Hardy","doi":"10.1093/SHM/12.2.293","DOIUrl":"https://doi.org/10.1093/SHM/12.2.293","url":null,"abstract":"Public health concern with food safety and food poisoning emerged in Britain in the 1880s following the first indication that acute gastric illness was caused by a specific organism. Although incidents were for many years only sparsely reported, the central medical department and its scientists were anxious to extend their knowledge of the incidence, specific causal organisms, and epidemiology of the illness. This paper argues for a widespread incidence of food poisoning in Britain in the nineteenth century and traces the social economic, and hygienic contexts within which it occurred. As deadlier infections retreated, food poisoning became an increasing concern of local and national health authorities, who sought both to raise public awareness of the condition as illness, and to regulate and improve food handling practices. Notification of cases was begun in 1939, and this, together with social changes during and after the Second World War, produced an escalating spiral of reported incidents which still continues. This trend, it is argued, is essentially an artefact, whose significance is reduced if considered in its broader historical context.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78994934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article shows that recourse to expert medical judgement for authenticating miracles has medieval roots which lead to the thirteenth century. It provides a survey of those cases in the printed versions of canonization processes from c. 1200 to c. 1500 where medical men actively appeared as witnesses. It shows how, from the second half of the thirteenth century, many canonization processes (overwhelmingly in southern Europe) included at least one medical man who witnessed or gave expert testimony as a supplier of medicine. The physicians who appeared as expert witnesses were expected to rule out the possibility that there was a natural explanation for the wonderous cure. To acquire medical confirmation that a certain cure was miraculous seemed highly desirable to those wishing to substantiate claims of sanctity. Physician witnesses were often called upon to evaluate cases of which they had personal knowledge because of the medical know-how they possessed: however, medical science was not considered so universal that any physician could review the case (as is theoretically the case today in the medical council at the Vatican). Thus, to the therapeutic function of physicians and surgeons in southern Europe from the second half of the thirteenth century, a hitherto neglected duty should be added: whenever necessary, the community as well as the local ecclesiastical authorities expected the suppliers of medical services to contribute to the formal recognition of an apparent saint.
{"title":"Practitioners and saints: medical men in canonization processes in the thirteenth to fifteenth centuries.","authors":"J. Ziegler","doi":"10.1093/SHM/12.2.191","DOIUrl":"https://doi.org/10.1093/SHM/12.2.191","url":null,"abstract":"This article shows that recourse to expert medical judgement for authenticating miracles has medieval roots which lead to the thirteenth century. It provides a survey of those cases in the printed versions of canonization processes from c. 1200 to c. 1500 where medical men actively appeared as witnesses. It shows how, from the second half of the thirteenth century, many canonization processes (overwhelmingly in southern Europe) included at least one medical man who witnessed or gave expert testimony as a supplier of medicine. The physicians who appeared as expert witnesses were expected to rule out the possibility that there was a natural explanation for the wonderous cure. To acquire medical confirmation that a certain cure was miraculous seemed highly desirable to those wishing to substantiate claims of sanctity. Physician witnesses were often called upon to evaluate cases of which they had personal knowledge because of the medical know-how they possessed: however, medical science was not considered so universal that any physician could review the case (as is theoretically the case today in the medical council at the Vatican). Thus, to the therapeutic function of physicians and surgeons in southern Europe from the second half of the thirteenth century, a hitherto neglected duty should be added: whenever necessary, the community as well as the local ecclesiastical authorities expected the suppliers of medical services to contribute to the formal recognition of an apparent saint.","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90571234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L'origine du virus de la variole est discute et proviendrait vraisemblablement de l'infection de vaches ou de chevaux
天花病毒的起源是有争议的，可能来自牛或马的感染
{"title":"The orgins of vaccinia virus--an even shorter rejoinder.","authors":"D. Baxby","doi":"10.1093/SHM/12.1.139","DOIUrl":"https://doi.org/10.1093/SHM/12.1.139","url":null,"abstract":"L'origine du virus de la variole est discute et proviendrait vraisemblablement de l'infection de vaches ou de chevaux","PeriodicalId":68213,"journal":{"name":"医疗社会史研究","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73731866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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