This article traces the remarkable transition of the Dutch neurosurgeons from a rather shielded group of specialists in the early 1950s to a publicly accountable professional community by the mid-1980s. It describes how the neurosurgeons aligned their specialty to the problems and sentiments of the welfare state. In doing so, they exchanged traditional notions of expert authority and doctor anonymity for public performances of expertise that enabled them to stage their specialty in a way that resonated with society and served their professional goals. During this professionalization process, they increasingly came to embody the public image they enacted, seamlessly blending strategic role-play with the genuine performance of professional identity. By analyzing the way the Dutch neurosurgeons adapted their expert performances to the changing rules of expertise in postwar society, the article addresses the entangled relationship between medicine, media, the state, and society in the second half of the twentieth century.
As AIDS activists voiced their demands for "drugs into bodies" in the late 1980s, American scientists injected drugs into the body of a highly controversial research animal-the chimpanzee. This paper examines the controversy over the use of chimpanzees in U.S. HIV/AIDS research that led to the decline of chimpanzees as laboratory animals. The author suggests that the AIDS epidemic raised the public profile of laboratory chimpanzee research, heightening its pre-existing financial and ethical problems. The scientific and lay debate sparked by chimpanzee AIDS research demonstrates the intersection of ethics and economics in shaping laboratory research practices and disease politics in the late twentieth century. As animal advocates constructed laboratory chimpanzees as close human relatives, innocent of the imagined sins of people with AIDS, researchers working with chimpanzees confronted their ambiguity as an HIV animal model and the long-term costs of maintaining HIV-infected animals. By the late 1990s, an animal that had been a promising AIDS model became a public relations headache and a major expense for biomedical research. The pushback to the use of chimpanzees in AIDS research helps scholars understand how American scientists, activists, and animal advocates have made sense of the enmeshed concerns of human and animal welfare in a time of epidemiological crisis.
This positioning paper surveys recent historical scholarship on objects and material culture relating to health and medicine. Analyzing scholarship under four main themes-professional medicine; everyday health; spaces, places, and environments; and consumption, globalism, and colonialism-the paper demonstrates the vibrancy and breadth of the field; it outlines how scholarship across these themes has viewed a wide range of objects and forms of materiality as not only integral to medical knowledge and health practices in the past but has often uncovered alternative, subversive, and multiple ways of knowing and doing that are inaccessible by the written word alone. The paper ends by providing possible future directions for scholars keen to further explore the role of materiality in medical knowledge making and practice. In particular, it suggests how scholars might fruitfully expand the material categories they work with, adopt "material time" and include more critical self-awareness in their research.
In 1965, a public health nurse established a community-based maternal and child health center in a predominantly low-income Black neighborhood in Detroit. Funded by the Office of Economic Opportunity and administered by the Visiting Nurses Association, the Mom and Tots Neighborhood Center was staffed by community members and established to serve the needs of the community as identified by the community. This article analyzes the different meanings the center held for the women who staffed the center, the clinicians who provided care, and the community members it served during the turbulent years of the late 1960s. It highlights the entangled politics of community health provision, whereby efforts to increase health services to low-income Black women confronted the race, gender, and class biases of clinicians, administrators, and politicians. These politics reflect the contested status of community health centers and the value placed on the health of the patients they served.
This article advances a method developed by a historian and a mechanical engineer to learn about premodern amputees. Using a sixteenth-century iron hand from Germany as a foundational case study, the authors illustrate four components of an experimental approach for investigating fragile artifacts of prostheses. First, they present the creation of historically contextualized activities of daily living (ADLs), a concept used in modern prosthesis usability assessments. Second, the authors address the use of computer-aided design (CAD) and 3D printing technology to develop models of artifacts collaboratively. Next, they explain the significance of engaging with external interlocutors with crucial perspectives on disability advocacy and inclusivity. Finally, the authors suggest how to design experiments with ADLs to test 3D-printed models. Together, these components create a physical object and material encounters that can push exploration of prosthetic artifacts-one of the few direct sources of premodern amputees' lived experience-into a new frontier of research.
Many people now take knowledge of the fetal heartbeat for granted. Despite this, it wasn't until 1818, following the invention of the stethoscope and popularization of the technique of auscultation, that the fetal heartbeat was first discovered. Listening to the fetal heartbeat enabled practitioners to confirm the existence of pregnancy, gain information on the internal positions of the fetus and the placenta, and determine the life or death of the fetus in utero. Additionally, signs from the stethoscope provided guidance for practitioners when dealing with long or difficult labors. This article examines the work and writings of the early key players in this story, emphasizing the impact of enthusiastic stethoscope advocacy on Irish obstetric practitioners' uptake of the instrument and how the changes in practice that stemmed from these changes went on to impact practitioners in Scotland.
This article examines the specific uses and meanings of medical photographs depicting skin color variation produced by Dr. Hugh Stannus Stannus in early twentieth-century colonial Malawi. The sociopolitical environments in which the images were produced and interpreted rendered Black bodies as objects of medical inquiry, and the images stood as evidence for a range of racialized scientific ideas. This article advocates for an analysis of historic photographs such as these that attends to their historic functions, the visceral responses they evoke for the contemporary viewer, as well as the afterlives of the medical images. This leads to new understandings of the relationships between race, colonialism, and medicine in past and present perspectives, including "new ways of seeing" that emerge following rereading of Stannus's photographs with contemporary concerns. This, in turn, raises questions of how we can ethically study the past and develop approaches of looking at historic images in ways that are sensitive to the violence enacted on the bodies of the colonized.
As an immediate target of post-Unification legislation, Italian midwives were subject to national efforts to standardize educational and professional practices. As a material emblem of these initiatives, the midwife's bag signified both a recognizable marker of midwives' new professional status and a mechanism for the increased surveillance directed toward them. Drawing on the material feminism of scholars like Donna Haraway and Karen Barad, the author considers three objects contained within the midwife's bag-syringes, stethoscopes, and birth registers-and the associated technologies of asepsis, auscultation, and statistical enumeration. In physical birthing rooms and on the pages of midwifery's new professional journals, the embodied practices associated with, rationale for, and impacts of novel obstetrical objects were negotiated. These technologies were part of the ongoing production of particular kinds of birthing and fetal bodies, ones that were both known and increasingly defined by technologically derived data and measurement.
From the earliest days of the Swiss Mission Romande's establishment in Southeast Africa at the end of the nineteenth century, photography, just becoming an accessible technology for the committed amateur, held a role in the everyday lives of missionaries. Patrick Harries has argued that Swiss missionaries' photographs of unfamiliar landscapes and cultural practices in this region "conserved and diffused the mixture of apprehension and excitement with which [they] viewed Africa." This paper takes up this claim to consider how photography and photographic ways of seeing mediated, and reflected shifts in, the specific ambivalence that missionaries felt toward the role of medicine in evangelistic work and the establishment of the mission within this region. The author suggests that by capturing African audiences in photographs, missionaries aimed to communicate the value of the "medical mission" for the real and imagined European audiences of those photographs.
This article examines the usage of alternative therapies such as AL-721 and metaphysical healing by gay men and AIDS patients during the HIV/AIDS epidemic of the 1980s and 1990s. The usage of alternative therapies during the epidemic has usually been framed by scholars as a foil to more well-studied areas of palliative care. Instead, this article argues that these alternative therapies and lifestyle regimens are worthy of greater discussion as this alternative medical marketplace offered patients a meaningful choice in managing their illness. Furthermore, this alternative medical marketplace was a patient-regulated one, where the patients themselves decided who was and who was not a legitimate medical practitioner. Gay publications in Texas became a major hub for information and discussion about alternative treatments, which indicates that medical pluralism flourished even outside of AIDS organizations in New York and Los Angeles.
In April 1965, the Turkish Parliament passed the law legalizing birth control, including the pills and the use of intrauterine devices. This article examines the beginnings and expansion of family planning in Turkey in the 1960s by tracing the encounters of American experts, Turkish physicians along with bureaucrats, and thousands of urban squatter dwelling and rural women and men. Different from the previous historical accounts framing family planning as an insular and state-driven modernization project, it provides a transnational history of family planning in Turkey by unearthing intimate links between the discourses of development and histories of family, sexuality, and reproduction. By using Population Council documents, Turkish official papers, Parliament minutes, visual materials, and national and feminist press accounts, this article demonstrates that family planning practices with new technologies of contraceptives constituted often-neglected but indispensable components of infrastructure in the formation of technologies of governance in Turkey in Cold War context.
Founded in 1965 during the War on Poverty, the Community Health Center (CHC) program was created to meet the health needs of poor Americans while employing patients in clinic oversight and operations. This study explores the historical roots and implications of community participation in health care. The paper focuses on the foundational years of the CHC program, with attention to the establishment of the Tufts-Delta Health Center (TDHC) in Mound Bayou, Mississippi, and the struggles to realize community control in a clinical context. The analysis reveals the tensions between outsider activists, local elites, and impoverished community members over CHC governance, reflecting broader conflicts over community participation in health care. By scrutinizing the practical and ideological conflicts at TDHC, this essay illuminates the promises and limitations of federal grassroots health initiatives and underscores the complexities of genuine patient authority in health care delivery.
During the late nineteenth and early twentieth centuries, Iraq was visited by two influenza pandemics-one in 1889-1893 (the so-called Russian flu), the other in 1918-1920 (the so-called Spanish flu). These pandemics occurred during two completely different political contexts in the history of Iraq-that of the Ottoman Empire, which ruled Iraq since the sixteenth century, and that of the British wartime occupation, which brought an end to Ottoman rule in the region during World War I. The different political contexts in which influenza appeared in Iraq produced significant differences in how Ottoman and British authorities responded to the disease. Specifically, while influenza was widespread across Iraq during both pandemics, the Ottomans largely ignored the disease, whereas the British tracked and studied it. Despite these differences, however, there were certain similarities across both pandemics. For one, there were subsequent outbreaks of influenza following the worst of each pandemic, but these did not meaningfully shape Ottoman or British public health priorities. Second, in both cases, there was uncertainty about the nature of influenza, much as there was elsewhere in the world. As this article demonstrates, the history of influenza in late Ottoman and British occupied Iraq was one marked by continuity and change.
The 1950s were a decade of remarkable advances in tuberculosis research globally, with Kenya emerging as a key site for developing new control and treatment regimens. Yet historical source material and consequently medical histories are largely silent on the context of anticolonial war in which this work took place. This article argues that disease control efforts in postwar Kenya must be examined in the context of the Mau Mau uprising and uses photographs to probe the intersection of politics and health. Examining photographs of late colonial TB control initiatives, it highlights the stark contrast between these images and the concurrent realities and imageries of Mau Mau. Produced in contexts of omnipresent violence and deep uncertainty about Kenya's future, these medical photographs were instruments of colonial power and Western hegemony. Even as they reproduced a generic developmentalist vision of medical knowledge production, the specificities of Kenya's late colonial struggle reverberate throughout these images.
Arnold Rich (1893-1968) was an acclaimed pathologist and the first Jewish department chair at the Johns Hopkins School of Medicine. In his landmark text, The Pathogenesis of Tuberculosis, Rich continued to advance the concept of racial susceptibility to tuberculosis a decade after mainstream medicine recognized that environmental factors fueled the disease. While Rich fits into the historical narrative that embedded categories of race facilitated scientific racism, two characteristics unique to Rich help to explain why he persisted. First were the scientific origins of his theories. While racial theorists sought to prove racial difference through science, Rich used racial difference to prove his outlying theories of tuberculosis immunology. Second was his identity as a prewar Jewish person when America's focus on a racial binary pressured Jewish Americans to assimilate into white culture. Rich's life and research exemplify how examining scientific racism through an individual complicates and expands our understanding of how race is constructed in the United States.
In the 1950s, the idea of sex change increasingly assumed the mainstay of public interest. As psychiatrists and psychologists developed new understandings of gender, the role of surgeons is often overlooked in the early history of sex reassignment. This article explores the work of one such doctor, Elmer Belt, a urologist based in Los Angeles. Between 1953 and 1962, Belt operated on twenty-nine male-to-female patients in the face of ethical and material obstacles. Working closely with Harry Benjamin, Belt developed a surgical technique that transplanted the testes inside the abdomen rather than involving full castration. He became involved in the famous case of Agnes Torres, on which other high-profile scientists based their invention of such seminal concepts as "passing" and "gender identity." Belt's utilization of Agnes as exemplary evidence to support his technique illustrates how and why testicular retention remained a heated topic in the development of transsexual science.
The author traces the evolution of Seoul National University Hospital (SNUH) and its predecessors, focusing on their transformation from the 1960s to the 1980s. Starting as an impoverished governmental hospital of a postcolonial country, it grew into a major South Korean biomedical corporation with many faculty members with American training, a new main building with the latest technologies, and a larger independent budget supported by the National Health Insurance (NHI). However, this evolution accompanied multiple issues stemming from overcrowding, which resulted in short and skimpy consultations, a poor environment, staff exploitation, and various minor crimes. Yet the crowds in the hospital assisted young doctors' training and some faculty members' research. The author explains this complexity by analyzing the American aid's legacy alongside the NHI's roles. This explains the limitations to the U.S. attempt to shape Korea's medicine amid its state-driven industrialization and health insurance evolution under a military dictatorship, which partly reflected the colonial heritage.
This special issue explores the opportunities and challenges of using photographs to write histories of health and healing in colonial and postcolonial Africa. Since the late nineteenth-century introduction of photographic technology to Africa, it has been employed in a myriad of manners and settings related to health. Yet while photographs abound in medical histories of Africa-typically as provocative yet unexplored cover photos or illustrations-historians of health and healing in Africa have not systematically utilized photographs as historical sources that augment or contest analyses based on written sources. This special issue introduction proposes a set of tools that establish the intersection of visual, medical and African history as a productive analytic: (1) confronting the fiction of photographic transparency through contextualization, (2) close viewing of and ethical engagement with images, and (3) centering the fictions of photographic truth as historical subjects in themselves. These tools are demonstrated with reference to the contributions in the special issue, dealing, variously, with colonial-era Kenya, Malawi, Mozambique, and South Africa.
Over the second half of the nineteenth century, thousands of Americans were admitted to schools for so-called idiotic children, later known as institutions for the feebleminded and linked to the Eugenics movement. While idiocy is often presumed to be the antecedent of intellectual disability, an analysis of the stories of three hundred children admitted to one such institution over a forty-year period demonstrates an unexpected diversity of appearances, abilities, and behaviors. Within the walls of the institution, idiocy was composed of children whose perceived abilities deviated from the expectations of their social position. Families further shaped the diagnosis of idiocy by negotiating the timing of admission for their children, influenced not only by personal factors, but by shifting educational and employment opportunities, and cultural tolerance of diversity. Consequently, idiocy became the broadest descriptor of disability during the nineteenth century.
This article investigates the history of Sir Richard Carew's warming stone. Through examination of handwritten notebooks, letters, and printed medical pamphlets, it recovers the theoretical framework shaping the stone's design as a cure, the creation and launch of medical business in early modern London, the use of cheap print in promoting medical services, and the place of cure testimonials in the marketing of early modern health technologies. It also showcases the dynamism inherent in the design, production, and marketing of the early modern health devices. The article extends histories of early modern therapeutics beyond pharmacy to include medical devices and shines light on new historical actors, knowledge practices, and commercial ventures in early modern health care. It also demonstrates the utility of adopting history of technology frameworks to study early modern health objects and posits that further study of everyday health technologies can enrich histories of medicine.