Preprint Articles

“Four Corners and a Void”: Idiocy and Childhood Disability in Nineteenth-Century America

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Posted:
Sat, January 20, 2024

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.

The Creation and Circulation of Evidence and Knowledge in American Medicine through the Lens of the “Husband’s Stitch”

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Posted:
Tue, January 30, 2024

Physicians in the twentieth century routinely used episiotomy—a cut made during childbirth—to better facilitate labor, using the evidence of their experiences that it was useful. But physicians were not alone in producing evidence regarding episiotomy and its repair. Here I consider how three groups—male physicians, husbands, and laboring women—were involved in creating evidence and circulating knowledge about episiotomies, specifically, the intention of its repair, the so-called “husband’s stitch,” to sexually benefit men. By doing so I seek to consider the meanings of evidence within medicine, evidence as a basis for challenging the hegemony of medicine by lay women, and how medical knowledge is produced and shared among physicians and non-physicians.

“A Person Like Me”: Systemic Lupus Erythematosus, Gender, and Racial Immunity in the Twentieth-Century United States

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Posted:
Tue, January 30, 2024

Systemic lupus erythematosus (SLE) is an autoimmune disorder that affects mostly women and disproportionately Black women. Until the 1940s, SLE was rarely diagnosed in Black Americans, reflecting racist medical beliefs about Black immunity. In the 1940s and 1950s, SLE and its treatment were part of a patriarchal narrative of American industrialization. By the 1960s, newer diagnostic techniques increased recognition of SLE, especially among Black women; medical thinking about SLE shifted from external causes like infection or allergy to autoimmunity, which emphasized biological, genetically determined racial difference. In the 1970s and 1980s, an advocacy structure crystalized around memoirs by women with SLE, which emphasized the experiences of able-bodied, economically privileged white women, while Black feminist health discourse and SLE narratives by Black authors grappled with SLE’s more complicated intersections. Throughout the twentieth century, SLE embodied immunity as a gendered, racialized, and culturally invested process.

Mobile Monkeys and Modified Microbes: Medical Experimentation between Metropolitan and Colonial Laboratories, 1880–ca. 1925

Author(s):
Posted:
Wed, January 31, 2024

Following the medical breakthroughs of Pasteur and Koch after 1880, the use of simians became pivotal to laboratory research to develop vaccines and cultivate microbes through the technique of serial passage. These innovations fueled research on multiple diseases and unleashed a demand for simians, which died easily in captivity. European and American colonial expansion facilitated a burgeoning market for laboratory animals that intensified hunting for live animals. This demand created novel opportunities for disease transfers and viral recombinations as simians of different species were confined in precarious settings. As laboratories moved into the colonies for research into a variety of diseases, notably syphilis, sleeping sickness, and malaria, the simian market was intensified. While researchers expected that colonial laboratories offered more natural environments than their metropolitan affiliates, amassing apes, people, microbes, and insects at close quarters instead created unnatural conditions that may have facilitated the spread of undetectable diseases.

Dreams: Charcot’s Last Words on Hysteria

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Posted:
Wed, January 31, 2024

Jean-Martin Charcot (1825–1893), the leading neurologist of his time, is best remembered for his studies on hysteria presented in clinical lectures at the Paris Salpêtrière hospital. Developing the concept of traumatic male hysteria after accidents in which patients suffered slight physical damage led him to advance a psychological explanation for hysteria. Traumatic hysteria is the context for a close reading of Charcot’s “last words” based upon a final unpublished lesson in 1893. This case history concerns a seventeen-year-old Parisian artisan whose various signs of hysteria developed following a dream in which he imagined himself the victim of a violent assault. Charcot identifies the dream/nightmare as the “original” feature determining traumatic hysteria. The dream sets in motion an overwhelming consciousness followed by a susceptibility to “autosuggestion” producing somatic signs of hysteria. Charcot’s final lesson on dreams thus culminates his study of the psychological basis of traumatic hysteria.

Segregated in Life and Death: Arnold R. Rich and the Racial Science of Tuberculosis

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Posted:
Fri, March 22, 2024

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.

An Artificial Appetite: The Nineteenth-Century Struggle to Define Habitual Drunkenness

Posted:
Tue, April 30, 2024

After discovering in 1811 that alcohol existed as a discrete chemical substance in all intoxicating drinks, physicians reconsidered the individual’s responsibility for becoming a compulsive drinker. Looking to science and medicine for legitimacy, temperance reformers ascribed a deleterious agency to alcohol and personified it as an agent of physiological destruction. Alcohol destroyed the body and transformed natural alimentary desires into a compulsive artificial appetite for alcohol. Reformers, prohibitionists, and physicians were troubled that alcohol possessed the ability to destroy the physical capacity for the power of choice. Ascribing agency to alcohol destabilized long-standing understandings of intemperance as a vice and imbued habitual drunkenness with medical meanings. However, most professionals remained anxious about absolving the habitual drunkard of all responsibility, especially for taking the first drink. An inchoate attempt to capture the medical and moral dilemmas of compulsion, habitual drunkenness represents a conceptual missing link in the genealogy of addiction.

A Clinic for the People: Toward an Antiracist Psychiatry at the Tuskegee Institute 1947–1965

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Posted:
Tue, April 30, 2024

From 1947 until 1963, a small group of psychiatrists from the Tuskegee Veterans Administration Hospital ran a small Mental Hygiene Clinic designed to provide outpatient care and education to the Black residents of Macon County, Alabama. In an analysis of the clinic and the work of its Director, Dr. Prince Barker, we see the ways that Black psychiatrists tried to develop an antiracist approach to psychiatry and to develop their own autonomy in segregated Alabama. But there were limitations to this work. Tensions between the state funding body, local politics, and the internal racism of psychiatry itself all made it difficult for Tuskegee psychiatrists to provide alternatives to care beyond the veil of the color line.

The Citizen as a Public Health Actor: Complaints as Public Engagement with Aedes Mosquito Control in Singapore, 1965–1985

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Posted:
Tue, April 30, 2024

In 1986, the World Health Organization heralded Singapore as a model for the control of dengue fever, a viral disease spread by the Aedes aegypti mosquito. Between 1965 and 1985, public health officials successfully employed educational campaigns and mandatory home inspections to convince citizens to guard against mosquito breeding at home. Although this story appears to recapitulate standard narratives of top-down progress in Singapore, this paper argues that the significant role of the public in public health has been overlooked. Citizens complained frequently, sometimes publicly, to public health authorities and often compelled direct responses from them. Through these complaints, citizens modified official anti-mosquito measures and expanded the reach of public health. Public health in Singapore thus appears not simply as the imposition of an autonomous states vision onto a docile or even resistant citizenry but as a coevolution of the state and the public.