Preprint Articles

The Origins of Family Planning in Tunisia: Reform, Public Health, and International Aid

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Posted: 
Tuesday, September 25, 2018
Summary: 

This article explores the origins of the national family planning program in Tunisia during the 1960s. It moves beyond previous interpretations of the global population control movement that emphasized external intervention at the hands of international organizations. Instead it analyzes the mutually beneficial partnership between Tunisian president Habib Bourguiba and the Population Council, an American organization committed to reducing population growth. Using Tunisian sources and Population Council records, it argues that after independence in 1956, Bourguiba sought to address France’s underdevelopment of public health during the colonial period with robust reforms and international aid. Implementing a family planning program enabled Bourguiba to acquire resources that contributed to training Tunisian medical personnel, funding clinics and health services, and increasing the distribution and circulation of contraception. This article demonstrates that actors in the Global South were not mere beneficiaries of international health initiatives following decolonization; they were active participants and negotiators of their implementation at home.

Gender and Cortisone: Clinical Practice and Transatlantic Exchange in the Medical Management of Intersex in the 1950s

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Posted: 
Monday, October 1, 2018
Summary: 

This article complicates the history of the standardization of intersex case management developed at the Johns Hopkins Hospital in the 1950s by focusing on clinical practices and logics and the transatlantic circulation of knowledge. Using patient records and published studies, I follow the exchanges between pediatric endocrinologists Lawson Wilkins (Pediatric Endocrinology Clinic, Baltimore) and Andrea Prader (University Children’s Hospital, Zürich) on cortisone treatment for children with congenital adrenal hyperplasia (CAH), on psychosexuality and gender role, on choosing and changing the sex of intersex children, and on genital surgery. I argue that a focus on the transatlantic exchanges between these two clinics illuminates a more complex genealogy of modern intersex case management. It also provides insight into how physicians understood their clinical practice and sheds light on the messiness and pragmatic contingencies of what in retrospect only appears to have been a consistent treatment regime.

The Mist Tent: An Analysis of Therapeutic Change in the History of Cystic Fibrosis Care

Posted: 
Tuesday, October 16, 2018
Summary: 

Mist tent therapy for cystic fibrosis went through a rise and fall in popularity between the 1950s and 1970s, providing an opportunity to explore the nature of therapeutic change in medicine. The therapy “worked” in the context of a particularly grim life expectancy in the early 1950s and in the setting of a comprehensive therapeutic program that began in Cleveland in 1957. Although clinical studies published in the 1970s provided evidence that mist tents were ineffective or even harmful, these later studies were not necessarily more robust than earlier studies that provided evidence of mist tent efficacy, suggesting that other factors may have also contributed to mist tent abandonment. In fact, the unpalatable nature of mist tent therapy, which was described by one doctor as akin to incarceration, and studies that questioned the theoretical underpinnings of the therapy also played important roles in the eventual abandonment of mist tents.

John Houghton and Medical Practice in London c. 1700

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Posted: 
Sunday, October 28, 2018
Summary: 

This article considers the evidence for medical practice in London c.1700 provided by A Collection for the Improvement of Husbandry and Trade (1692–1703) by the apothecary and Fellow of the Royal Society, John Houghton (1645–1705). Houghton discusses how products are used medicinally, as well as the necessary qualifications for a physician, and reports his own experiments and health experiences. His advertisements reveal the range of (largely medical) products he could himself supply, but he also offered an information service, often for medical practitioners, throwing light on both the supply and demand for medical practitioners in different communities and the desirable attributes of shops. Whereas most sources used to uncover medical practice highlight conflict and competition, Houghton’s approach emphasizes consensus and cooperation, partly for his own ideological and commercial reasons, and partly reflecting the emergence of new forms of medical practice supported by the new science and by genteel consumer demand.