Preprint Articles

Moving Away from the “Medical Model”: The Development and Revision of the World Health Organization’s Classification of Disability

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Posted: 
Thursday, April 11, 2019
Summary: 

Recently, there has been a prominent call in the history of medicine for greater engagement with disability perspectives. In this article, I suggest that critiques of the so-called medical model have been an important vehicle by which alternative narratives of disability entered the clinical arena. Historians of medicine have rarely engaged with the medical model beyond descriptive accounts of it. I argue that to more adequately address disability perspectives, historians of medicine must better historicize the medical model concept and critique, which has been drawn upon by physicians, activists, and others to advance particular perspectives on disability. My present contribution describes two distinct formulations of critique that originated in differing interest groups and characterized the medical model alternatively as insufficient and oppressive. I examine the World Health Organization’s efforts to incorporate these distinctive medical model critiques during the development and revision of its International Classification of Impairments, Disabilities, and Handicaps.

Between Defectological Narratives and Institutional Realities: The “Mentally Retarded” Child in the Soviet Union of the 1930s

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Wednesday, April 17, 2019
Summary: 

This article analyzes the gap between the defectological narrative of care and the reality of institutional life for children with learning disabilities in the Soviet Union of the 1930s. It shows that, under Stalin, the Soviet discipline of defectology entailed a promise of correction and social integration that aligned well with the official rhetoric of triumphant socialism and that incorporated new, specific ideological meanings into its long-standing narrative of care. I also show that the defectological narrative was rarely realized in practice due to not only scarce material resources but also a profound reversal of defectological and Marxist conceptions of labor. By analyzing the disconnect between rhetoric and reality in the treatment of “mentally retarded” children in prewar Stalinism, this article contributes to a deeper understanding of the Soviet system and ideology of care.

Designing Penfield: Inside the Montreal Neurological Institute

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Posted: 
Thursday, May 9, 2019
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Neurosurgeon Wilder Penfield (1891–1976) envisioned hospital architecture as a powerful medical tool. Focusing on two key interiors in the 1934 Montreal Neurological Institute (MNI)—the operating room and the foyer—this article engages newly accessible textual and material evidence to show Penfield’s intense involvement in the design of the building. A unique, tri-level surgical room, with a sophisticated setup for photography, made the MNI’s surgery interactive. The OR is discussed with regard to the relationship of doctors and architects and Penfield’s penchant for architectural travel. Subsequently, we visit the foyer as a spatial counterpoint to the operating room. Its design enabled a particular, Penfield-inspired view of the brain and recounted neurological history in the language of Art Deco design. An emphasis on axial movement pushed visitors to “consume” a work of sculpture, meticulously copied from another in Paris. The architecture of the MNI thus monumentalized Penfield’s accomplishments, by his own design.

Plague before the Pandemics: The Greek Medical Evidence for Bubonic Plague before the Sixth Century

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Posted: 
Sunday, June 23, 2019
Summary: 

Recent biomolecular evidence has proven that Yersinia pestis, the pathogen that causes bubonic plague, was infecting human hosts in Eurasia as early as the Bronze Age, far earlier than previously believed. It remains an open question, however, whether bubonic plague was affecting Mediterranean populations of classical antiquity. This article evaluates the textual evidence for bubonic plague in classical antiquity from medical sources and discusses methodologies for “retrospective diagnosis” in light of new developments in microbiology. A close study of Greek medical texts suggests that bubonic plague was unfamiliar to medical writers until sometime before the second century AD, when sources cited by Rufus of Ephesus report a disease that resembles bubonic plague. Rufus of Ephesus describes this disease around AD 100 , and Aretaeus (fl. ca. AD 50 or 150) appears to describe the same disease as well. Intriguingly, the disease then disappears from our sources until late antiquity.