Bulletin of the History of Medicine
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TO APPEAR IN - upcoming issues of the Bulletin of the History of Medicine
The “Ice Age” of Anatomy and Obstetrics: Hand and Eye in the Promotion of Frozen Sections around 1900
By: Salim Al-Gailani
(Posted September 8, 2016)
SUMMARY: In the late nineteenth century anatomists claimed a new technique—slicing frozen corpses into sections—translated the three-dimensional complexity of the human body into flat, visually striking, and unprecedentedly accurate images. Traditionally hostile to visual aids, elite anatomists controversially claimed frozen sections had replaced dissection as the “true anatomy.” Some obstetricians adopted frozen sectioning to challenge anatomists’ authority and reform how clinicians made and used pictures. To explain the successes and failures of the technique, this article reconstructs the debates through which practitioners learned to make and interpret, to promote or denigrate frozen sections in teaching and research. Focusing on Britain, the author shows that attempts to introduce frozen sectioning into anatomy and obstetrics shaped and were shaped by negotiations over the epistemological standing of hand and eye in medicine.
KEYWORDS: frozen sections, anatomy, obstetrics, visual aids, representation
“The Weight of Perhaps Ten or a Dozen Human Lives”:
Suicide, Accountability, and the Life-Saving Technologies of the Asylum
By: Kathleen Brian
(Posted September 8, 2016)
SUMMARY: By accounting for the law’s productive capacity to structure asylum physicians’ encounters with suicide, this essay argues that the antebellum asylum was a technology for the preservation of life. The essay first shows how suicide’s history as a crime encouraged popular attributions of suicide to insanity. What began as a tactic to protect survivors, however, ended by bolstering the professional claims of asylum medicine. Initially it appeared there was much to gain from claiming suicide as their own, but dominion over prevention in fact rendered asylum physicians and their staffs vulnerable in unanticipated ways: for while agents of suicide were effectively evacuated of legal responsibility, a variety of laws made physicians more accountable than ever. Focusing on medical superintendent Amariah Brigham and his staff at the New York State Lunatic Asylum shows how the anxiety of assuming guardianship over the suicidal created networks of accountability that profoundly affected daily life.
KEYWORDS: suicide, asylum, law, power
Medical Research in Stalin’s Gulag
By: Golfo Alexopoulos
(Posted July 12, 2016)
SUMMARY: Recently declassified Gulag archives reveal for the first time that the Stalinist leadership established medical research laboratories in the camps. The present work offers an initial reading of the medical research conducted by and on prisoners in Stalin’s Gulag. Although Gulag science did not apparently possess the lethal character of Nazi medicine, neither was this work entirely benign. I argue that the highly constrained environment of the Stalinist camps distorted medical science. Scientists were forced to produce work agreeable to their Gulag administrators. Thus they remained silent regarding the context of mass starvation and forced labor, and often perpetuated Gulag myths concerning the nature of diseases and the threat of deceptive patients. Rather than aggressive treatment to save lives, they often engaged in clinical observations of dead or dying patients. At the same time, a few courageous scientists challenged the Gulag system in their research, in both subtle and overt ways.
KEYWORDS: medical research, Gulag, Stalin, Soviet Union, camps, starvation, vitamin deficiency, prisoners, Soviet science
The Autobiographical Shoulder of Ernest Amory Codman: Crafting Medical Meaning in the Twentieth Century
By: Caitjan Gainty
(Posted July 12, 2016)
SUMMARY: This essay offers a reconsideration of the historical significance of Ernest Amory Codman’s autobiographical preface to his 1934 text The Shoulder, Rupture of the Supraspinatus Tendon and Other Lesions on or about the Subacromial Bursa and its reception, in its own time and at the end of the twentieth century. It concentrates on the aesthetics of identity and the ways in which these are woven into the political, professional, and cultural contexts of these two periods. It argues finally that Codman’s style of life writing, both in the autobiography and throughout his texts, served as an important historical actor that more generally demonstrates the possibilities in approaching the history of medicine from aesthetic angles. In this way, it also calls for a tabling of the more canonical concerns about the American medical profession in the twentieth century in order to focus more empirically on questions concerning the development of medical meaning more broadly conceived.
KEYWORDS: Ernest Amory Codman, failure, medical aesthetics, professionalization, outcome measurement, evidence-based medicine, autobiography
Blood, Soy Milk, and Vitality:
The Wartime Origins of Blood Banking in China, 1943–45
By: Wayne Soon
(Posted July 12, 2016)
SUMMARY: This article examines the multiple meanings of blood transfusion and banking in modern China through the history of the first Chinese blood bank, established by the Overseas Chinese in 1943 to solicit blood for the war effort. Through investigating the attitudes of Chinese soldiers and civilians toward the blood bank, this article argues for the multiplicity of motivations underpinning society’s attitudes toward blood banking and donation. Cultural notions of blood were an important but not the sole factor in their consideration. Ideas of nationalism and altruism played a role too. What eventually turned out to be most effective for most donors was the promise of eggs and soy milk for blood. Its economic value in the context of wartime scarcity was enough for many to abandon opposition to blood banking. By drawing attention to socioeconomic concerns in biomedical practices, this article provides an alternative examination of blood banking in modern societies.
KEYWORDS: blood bank, blood transfusion, technology transfer, blood donation, Robert Lim, World War II, military medicine, medical economy, modern China, medical practice
Marketing Masked Depression: Physicians, Pharmaceutical Firms, and the Redefinition of Mood Disorders in the 1960s and 1970s
By: Lucie Gerber and Jean-Paul Gaudillière
(Posted July 27, 2016)
SUMMARY: This article investigates the redefinition of depression that took place in the early 1970s. Well before the introduction of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, this rather rare and severe psychiatric pathology hitherto treated in asylums was transformed into a widespread mild mood disorder to be handled by general practitioners. Basing itself on the archives of the Swiss firm Ciba-Geigy, the article investigates the role of the pharmaceutical industry in organizing this shift, with particular attention paid to research and scientific marketing. By analyzing the interplay between the firm, elite psychiatrists specializing in the study of depression, and general practitioners, the article argues that the collective construction of the market for first-generation antidepressants triggered two realignments: first, it bracketed etiological issues with multiple classifications in favor of a unified symptom-oriented approach to diagnosis and treatment; second, it radically weakened the differentiation between antidepressants, neuroleptics, and tranquilizers. The specific construction of masked depression shows how, in the German-speaking context, issues of ambulatory care such as recognition, classification, and treatment of atypical or mild forms of depression were reshaped to meet commercial as well as professional needs.
KEYWORDS: depression, pharmaceutical firms, scientific marketing, antidepressants, screening, general practice