Preprint Articles

The Radicalization of Breast Cancer Surgery: Joseph Colt Bloodgood’s Role in William Stewart Halsted’s Legacy

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Tuesday, January 16, 2018
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Johns Hopkins’s surgeon William Stewart Halsted is renowned for popularizing the radical mastectomy, a disfiguring procedure that was overutilized during the 1900s. Cancer historians have questioned why Halsted, a meticulous surgical investigator, became more aggressive in his approach to breast cancer surgery when his own data failed to show prolonged patient survival. Joseph Colt Bloodgood, one of Halsted’s early surgical residents, Hopkins’s head of surgical pathology, and Halsted’s primary outcome data analyst, played previously unrecognized roles. Bloodgood was an aggressive surgeon with a “lynch law” approach to breast lesions. As a surgical pathologist, Bloodgood was irrationally opposed to intraoperative frozen section diagnosis. Bloodgood’s and Halsted’s unwavering trust in each other created an environment where shared beliefs trumped surgical reality. However, after Halsted’s death, Bloodgood recognized that they had been wrong and spent the rest of his life trying to reverse the progression while simultaneously “rewriting” details of his own involvement.

“He Must Die or Go Mad in This Place”: Prisoners, Insanity, and the Pentonville Model Prison Experiment, 1842–52

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Tuesday, January 16, 2018
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The relationship between prisons and mental illness has preoccupied prison administrators, physicians, and reformers from the establishment of the modern prison service in the nineteenth century to the current day. Here we take the case of Pentonville Model Prison, established in 1842 with the aim of reforming convicts through religious exhortation, rigorous discipline and training, and the imposition of separate confinement in its most extreme form. Our article demonstrates how following the introduction of separate confinement, the prison chaplains rather than the medical officers took a lead role in managing the minds of convicts. However, instead of reforming and improving prisoners’ minds, Pentonville became associated with high rates of mental disorder, challenging the institution’s regime and reputation. We explore the role of chaplains, doctors, and other prison officers in debating, disputing, and managing cases of mental disorder and the dismantling of separate confinement in the face of mounting criticism.

The Cowpox Controversy: Memory and the Politics of Public Health in Cuba

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Wednesday, January 17, 2018
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Vaccination played an important role in the formation of a national consciousness in Cuba, and vaccination’s earliest promoters dominate nationalist narratives of medical achievement on the island. This article investigates the intense hostility exhibited by the creole medical elite toward a pivotal figure in the history of smallpox vaccination in Cuba, Spanish physician Dr. Vicente Ferrer (1823–83), the first in the Americas to mass produce smallpox vaccine using calf vaccinifiers. I argue that anger and mistrust of both Ferrer and his innovatory vaccine production technology originated in the relationship between medical politics and cultural identity in late nineteenth-century Cuba. By the late nineteenth century, smallpox vaccination was linked to glorified memories of a Cuban creole-led vaccination program and a disinterested medical profession. Both Ferrer and his private institution for the mass production of “cowpox” became associated with destructive changes in public health, challenging cultural narratives and regional power structures.

Great Doctor History: A Personal Journey

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Wednesday, January 17, 2018
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For decades, physicians wrote much of the history of medicine, often “great man” histories that celebrated their colleagues’ accomplishments as part of a celebratory historical narrative. Beginning in the 1970s, social historians challenged this type of scholarship, arguing that it was Whiggish, omitted the flaws of the medical profession, left patients out of the story, and ignored issues of gender, race, and class. This Garrison Lecture revisits this history through the prism of my recent book, The Good Doctor: A Father, a Son, and the Evolution of Medical Ethics, which is essentially a biography of my physician father, Phillip Lerner, and an autobiography. In the talk I ask whether there is true historical value to biography or whether it should serve only as an adjunct to “real” social history. I also historicize my own career, something I chose not to do in the book.

A Research Enclave in 1940s Nigeria: The Rockefeller Foundation Yellow Fever Research Institute at Yaba, Lagos, 1943–49

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Wednesday, January 17, 2018
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This article examines the history of yellow fever research carried out in West Africa in the 1940s by Rockefeller Foundation scientists. It engages with a number of debates in the history of medical research in colonial Africa, including experimentation, the construction of the “field,” and biosecurity.