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TO APPEAR IN - upcoming issues of the Bulletin of the History of Medicine.

Gambling on the Protestants:
The Pathfinder Fund and Birth Control in Peru, 1958–1965

BY: Raúl Necochea López
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SUMMARY: Among the agencies involved in population control activities in the mid-twentieth century, none scored as many early victories in Latin America as did the Pathfinder Fund, founded by Procter & Gamble scion Clarence Gamble. This article analyzes a style in the delivery of family planning assistance in the developing world through the work of the Pathfinder Fund in Peru, the organization’s hub in South America, and shows how Pathfinder personnel collaborated with local Protestant institutions. Its Protestant allies helped Pathfinder set up and manage rapid interventions such as the production of pamphlets, the smuggling of contraceptives, and the enrollment of physicians as advocates of the use of intrauterine devices. Although these rapid interventions helped quickly disseminate information and certain technologies among a fortunate few, they also weakened legitimate state agencies, neglected the monitoring of the safety of the drugs supplied, and alienated allies with their high-handed boldness.
KEYWORDS: Protestant church, Pathfinder Fund, Clarence Gamble, Peru, religion, contraception, Latin America, family planning

Between East and West:
Polio Vaccination across the Iron Curtain in Cold War Hungary

BY: Dora Vargha
pdf

SUMMARY: In 1950s Hungary, with an economy and infrastructure still devastated from World War II and facing further hardships, thousands of children became permanently disabled and many died in the severe polio epidemic that shook the globe. The relatively new communist regime invested significantly in solving the public health crisis, initially importing a vaccine from the West and later turning to the East for a new solution. Through the history of polio vaccination in Hungary, this article shows how Cold War politics shaped vaccine evaluation and implementation in the 1950s. On the one hand, the threat of polio created a safe place for hitherto unprecedented, open cooperation among governments and scientific communities on the two sides of the Iron Curtain. On the other hand, Cold War rhetoric influenced scientific evaluation of vaccines, choices of disease prevention, and ultimately the eradication of polio.
KEYWORDS: Cold War, polio, Salk, Sabin, vaccines, Hungary, World Health Organization, children, eradication

Yaws, Syphilis, Sexuality, and the Circulation of Medical Knowledge in the British Caribbean and the Atlantic World
BY: Katherine Paugh
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SUMMARY: This history of the disease categories “yaws” and “syphilis” explores the interplay between European and African medical cultures in the early modern Atlantic world. The assertion made by both early modern and modern medical authorities, that yaws and syphilis are the same disease, prompts a case study of the history of disease that reflects on a variety of issues in the history of medicine: the use of ideas about contagion to demarcate racial and sexual difference at sites around the British Empire; the contrast between persistently holistic ideas about disease causation in the Black Atlantic and the growth of ontological theories of disease among Europeans and Euro-Americans; and the controversy over the African practice of yaws inoculation, which may once have been an effective treatment but was stamped out by plantation owners who viewed it as a waste of their enslaved laborers’ valuable time.
KEYWORDS: yaws, syphilis, sexuality, race, slavery, Thomas Thistlewood

The Foundations of Autism: The Law Concerning Psychotic, Schizophrenic, and Autistic Children in 1950s and 1960s Britain
BY: Bonnie Evans
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SUMMARY: While the origins of child psychiatry in Britain can be traced to the interwar period, contemporary concepts and methodological approaches to pathological mental development in children were not created until the 1950s and 1960s. It was at this time that one of the most salient and lasting diagnoses in child psychiatry, autism, was established through a network of intellectual, institutional, and legal changes in Britain. This article argues that the work of child psychiatrists at the Maudsley Hospital was central in driving these changes and uses archival sources from this hospital, along with other legal and intellectual sources, to explore attempts to conceptualize pathological thought in infants in the 1950s and 1960s. When the first epidemiological study of autism was published in 1966, this finally established the autistic child as a scientific, demographic, and social reality in Britain.
KEYWORDS: autism, psychosis, social science, Maudsley Hospital, Britain, mental deficiency, children, Mental Health Act 1959, institutional care

Cargo, “Infection,” and the Logic of Quarantine in the Nineteenth Century
BY: David Barnes
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SUMMARY: In the nineteenth century, maritime quarantine officials often paid more attention to ships’ cargo than they did to the health of passengers or crew members. Based on a close reading of the everyday practice of quarantine at Philadelphia’s Lazaretto (1801–1895), this article suggests that the historical significance of quarantine has been distorted by its association with the etiological debate over contagion and with xenophobic responses to immigration. In fact, the practice of quarantine rested neither on contagionist medical doctrine nor on nativism. Rather, it was based on the danger of infection, an elusive but fundamental concept in nineteenth-century public health. The concern about cargo rather than people—and the logic of infection it reflects—bespeak a widely shared set of perceptions of illness and public health in the first three-quarters of the nineteenth century that is not captured by discussions of contagion or of anti-immigrant bias.
KEYWORDS: quarantine, epidemics, yellow fever, Philadelphia, contagion, infection, immigration, public health

Exercises in Therapy—Neurological Gymnastics between Kurort and Hospital Medicine, 1880–1945
BY: Katja Guenther
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SUMMARY: This article focuses on the convergence of sports and medicine in the practice of neurological gymnastics (Übungstherapie) in the German-speaking world at the turn of the twentieth century. It shows how Übungstherapie first found receptive ground within the peripheral medical space of the spa town (Kurort). Übungstherapie appealed to Kurort patients because, as a form of neurological gymnastics, it drew on the cultural capital of the broader German gymnastics movement. Only later did Übungstherapie find a place in more mainstream medicine, recasting itself as an integral part of neurological practice. Recuperating the therapeutic aspects of neurology, this article suggests that the development of Übungstherapie contributed to the formation of neurology as an independent specialty, distinct from psychiatry and internal medicine. It thus demonstrates the importance of expanding the scope of historical study beyond the traditional boundaries of the mainstream in order to understand clinical, institutional, and disciplinary change.
KEYWORDS: neurological gymnastics, neurology, therapeutics, discipline formation, Turnen, spa medicine, Otfrid Foerster, disability

Metaphors and Images of Cancer in Early Modern Europe
BY: Michael Stolberg
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SUMMARY: Drawing on learned medical writing about cancer and on nonmedical texts that used cancer as a metaphor for hateful cultural, social, religious, or political phenomena that warranted drastic measures, this article traces the metaphors and images that framed the perception and experience of cancer in the early modern period. It finds that cancer was closely associated with notions of impurity and a visible destruction of the body’s surface and was diagnosed primarily in women, as breast and uterine cancer. Putrid, corrosive cancerous humor was thought not only to accumulate and eat its way into the surrounding flesh but also to spread, like the seeds of a plant, “infecting” the whole body. This infectious quality, the putrid secretions, and the often horrendous smell emanating from cancer victims raised fears, in turn, of contagion and were taken to justify a separation of cancer patients from the rest of society.
KEYWORDS: cancer, illness metaphors, early modern medicine, Susan Sontag

The Garrison Lecture
The Aesthetic Grounding of Modern Medicine

BY: John Harley Warner
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SUMMARY: This article focuses on visual choices that American physicians made in representing their profession, their work, and themselves during the decades when modern medical culture was set in place, the 1880s through the 1940s. Historians have emphasized the role that image played in the formation of modern medicine, but the visual images they have explored in connection to this process have tended to take a reductionist aesthetic identified with experimental laboratory science as emblematic of medical modernity. Explored here instead are several counterexamples—genres of self-representation in which medical students and physicians did not seek to link their identity with the laboratory and in some ways distanced themselves from the image and ideals of experimental science. The cultivation of these images invites us to see the cultural grounding of modern medicine as vastly more complex than a story scripted around the biomedical embrace of a stripped down, reductionist aesthetic.
KEYWORDS: medical photography, medical book collecting, medical libraries, national health insurance, Whitaker and Baxter, Luke Fildes’s The Doctor, Harvey Cushing, William Osler, aesthetics, medical history

Ex Utero: Live Human Fetal Research and the Films of Davenport Hooker
BY: Emily K. Wilson
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SUMMARY: Between 1932 and 1963 University of Pittsburgh anatomist Davenport Hooker, Ph.D., performed and filmed noninvasive studies of reflexive movement on more than 150 surgically aborted human fetuses. The resulting imagery and information would contribute substantially to new visual and biomedical conceptions of fetuses as baby-like, autonomous human entities that emerged in the 1960s and 1970s. Hooker’s methods, though broadly conforming to contemporary research practices and views of fetuses, would not have been feasible later. But while Hooker and the 1930s medical and general public viewed live fetuses as acceptable materials for nontherapeutic research, they also shared a regard for fetuses as developing humans with some degree of social value. Hooker’s research and the various reactions to his work demonstrate the varied and changing perspectives on fetuses and fetal experimentation, and the influence those views can have on biomedical research.
KEYWORDS: fetal research, biomedical ethics, medical film, history of embryology, therapeutic abortion, fetal imagery

“Patient Zero”: The Absence of a Patient’s View of the Early North American AIDS Epidemic
BY: Richard A. McKay
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SUMMARY: This article contextualizes the production and reception of And the Band Played On, Randy Shilts’s popular history of the initial recognition of the American AIDS epidemic. Published over twenty-five years ago, the book and its most notorious character, “Patient Zero,” are in particular need of a critical historical treatment. The article presents a more balanced consideration—a “patient’s view”—of Gaétan Dugas’s experience of the early years of AIDS. I oppose the assertion that Dugas, the so-called Patient Zero, ignored incontrovertible information about the condition and was intent on spreading his infection. Instead, I argue that scientific ideas in 1982 and 1983 about AIDS and the transmissibility of a causative agent were later portrayed to be more self-evident than they were at the time. The article also traces how Shilts’s highly selective—and highly readable—characterization of Dugas rapidly became embedded in discussions about the need to criminalize the reckless transmission of HIV.
KEYWORDS: HIV/AIDS, “Patient Zero,” patient, public health, origin, epidemic, North America, criminalization, Randy Shilts, Gaétan Dugas

From Skid Row to Main Street: The Bowery Series and the Transformation of Prostate Cancer, 1951–1966
BY: Robert Aronowitz
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SUMMARY: Between 1951 and 1966, more than 1,200 homeless, alcoholic men from New York’s skid row were subjected to invasive medical procedures, including open perineal biopsy of the prostate gland. If positive for cancer, men typically underwent prostatectomy, surgical castration, and estrogen treatments. The Bowery series was meant to answer important questions about prostate cancer’s diagnosis, natural history, prevention, and treatment. While the Bowery series had little ultimate impact on practice, in part due to ethical problems, its means and goals were prescient. In the ensuing decades, technological tinkering catalyzed the transformation of prostate cancer attitudes and interventions in directions that the Bowery series’ promoters had anticipated. These largely forgotten set of practices are a window into how we have come to believe that the screen and radical treatment paradigm in prostate cancer is efficacious and the underlying logic of the twentieth century American quest to control cancer and our fears of cancer.
KEYWORDS: cancer, prostate cancer, history of medicine, efficacy, risk, screening, bioethics


Bulletin of the History of Medicine

Bulletin of the History of Medicine is the official journal of the American Association for the History of Medicine.

Volume: 88 (2014)
Frequency: Quarterly
Print ISSN: 0007-5140
Online ISSN: 1086-3176