History 30626
Medicine and Public Health in American History
Fall Semester 2007
Instructor: Christopher Hamlin,
467 Decio; Hamlin.1@nd.edu
631-5092 or 234-1815 (home)
Office Hours: Tues 1-3 and by appointment
Texts:
Alan M. Kraut, Silent Travelers: Germs, Genes and the AImmigrant Menace@
Sinclair Lewis, Arrowsmith
James Whorton, Nature Cures: The History of Alternative Medicine in America
Sheila Rothman, Living in the Shadow of Death
Linda Nash, Inescapable Ecologies: A History of Environment, Disease, and Knowledge
Arthur Hertzler, The Horse and Buggy Doctor
Other readings on ereserve (bibliography below)
Course Objectives:
This course might be subtitled AAmerica as Medicine.@ Its premise is that American medical history is a part of broader issues
of American history. There are seven main related issues
* health as freedom in medical practice and individual choice
* the conceptualization of class, race, gender, age, lifestyle, and place in terms of health
* health and hygiene as the means of Americanization
* the expression of cultural and religious diversity in medicine
* health as the American dream
* health care as the battleground in American political economy
* health care as the locus of the American fascination with technology
By the end of this course you should have a good basic knowledge of differing conceptions of disease, health, and healing
throughout American history, the changing role and image of medicine and medical professionals in American life, and the
changing social and cultural meanings and entanglements of medical science and practice throughout American history. You
should also should also have developed stronger skills for reading the works of historians and evaluating them, for articulating
important historical questions and for utilizing primary sources in answering them. Finally, you should have acquired an
historical and critical context that will be of use in your own encounters with matters of health and medicine --as intelligent
citizens and as professionals on issues of public health and questions of medical ethics; and as creative thinkers about more
satisfactory modes of medical practice and health improvement and protection.
Requirements:
Attendance and Participation:
The course moves quickly and covers many themes. Our lectures and discussions will assume you have read the assigned
reading beforehand. Unless otherwise indicated, readings are due on Monday morning each week. Come even if you haven=t
done all the reading, but you=ll get much more out of the class if you have! Grading is done on a point system. I grade on the
basis that 90 of 100 points are required to earn an A.
1. Reaction Papers:
Three Reaction Papers to class readings, i.e. from articles, or book chapters. Please do not write on more than two chapters from
any single book.
Summarize the methods and findings of the article/chapter and then comment. Comments should address some of the following
1
sorts of questions:
What questions does this article raise for you and why?
Why are the events it discusses historically important?
\
What analogies come to mind with other cases, including contemporary situations?
How has this reading affected your understanding and assessment of medical issues?
If this is a primary source, what does it tell us about the time and place of its production; if it=s a
secondary source, what assumptions is the historian making in framing and answering the question?
Reaction Papers should be 2-3 pages double spaced. These are not to be essays in the formal sense; much more reactions B tell
me about what you=ve read and what you think of it. They are due in class at the end of the week for which the reading is
assigned. It is highly recommended to do at least one in the first half of the semester. 8 points each.
2. Panel-paper-presentation: the Virtual Medicine of the past B 32 points total
This assignment is the main research component of the course. There are multiple parts.
A. Article choice: Your first job will be to find an article in one of those journals (or, in a few cases, a book from the period)
that lends itself to addressing some aspect of America as medicine prior to 1960. Choose by a subject that interests you; that
connects to the themes of the course; avoid well known figures. Our library possesses a remarkable collection of medical
journals B roughly from the late 19th century on. At the end of the syllabus you=ll find a partial list of fascinating journals we
hold. Alternatively you may wish to consult the Surgeon General’s Catalogue, either in its bound version in our library or
electronically at the National Library of Medicine’s website [Indexcat] at [http://www.nlm.nih.gov/hmd/help/online/index.html].
Most journal articles are available relatively quickly through inter library loan.
Your job will be to provide a historical explanation of this article. Try to understand it from the author’s point of view. Why
has this person chosen to write; what does the article tell us about medical priorities, institutions, modalities at its time? To do
that will require background work in secondary, and, perhaps, other primary sources. Anyone who plans to address a topic
associated with the 18th or early 19th century should contact me immediately; otherwise article choice is due by September 24. (3
points)
B. Working groups: By October 1, I will assign you to a working group of 2-4 persons who are working in analogous areas for
discussion and presentation purposes. At that point we will set a date for a panel presentation of the group’s findings. About a
week before the presentation I will want to meet with the group. The purpose of that meeting will be to distill your readings into
bullet points and illustrations for lecture in the following week ~ in effect, I am asking the group to take partial responsibility for
the presentation of the class material. During that lecture period I will ask the group members to serve as a panel to amplify
points and respond to questions. You will be summoned as our expert representatives of these issues in the past, or perhaps
asked to adopt the persona of its author to defend the work. Note that presentation material will be subject to examination.
With regard to illustrations, the NLM, History of Medicine Division has a fine photographic collection
[http://wwwihm.nlm.nih.gov/cgi-bin/gw_44_3/chameleon?skin=nlm&lng=en]. For others see
http://www.nlm.nih.gov/hmd/resources/web/images.html (5 points for panel participation).
C. Term Paper: Each member of the working group is to produce a short term paper (8-10 pages, double-spaced with full
footnotes [preferred] or intratextual references and bibliography) on the article he or she has chosen. Again, your purpose is to
try to understand the article in the context of its times, and from its author’s viewpoints. To reiterated: Why has this person
chosen to write; what does the article tell us about medical priorities, institutions, modalities at its time? I suggest, but do not
absolutely require, a two-part format. The first section of your paper should be an apologia: e.g. AI am Dr. XY, physician of
Philadelphia in 1794. My education and medical background are … and this is what I experience, observe, conclude. The
second section should be a critical assessment B in retrospect how do we now understand Dr XY and her context? For
example, those working on colonial medicine might want to know more about Cotton Mather, or smallpox inoculation, or the
professional dispute between ministers and physicians. Those working on quackery might wish to focus on certain products or
kinds of therapy where it was prominent. This paper requires the use of additional sources. Please submit an annotated
bibliography of at least 5 satisfactory sources by Nov 5 (by annotation, I mean a line or two for each source on how the source
will help you; 5 points). I may be able to suggest sources, but you may also want to consult the on-line data base on the History
of Science and Technology and Medicine or perhaps the Database America: history and life. Both will need to be accessed
through the ND Library home page. The paper-grading template appended below will give you a sense of the I shall be
2
concerned with. The paper is due Dec. 3. (20 points).
3. Mid Term Exam B take home essays on major themes of lectures, readings, discussions, 15 points. Out October
17; due Oct. 31.
4. Final Exam B comprehensive take home exam on major themes of lectures, readings, discussions, 20 points. Out
December 6, due on the finals date.
5. Class participation B 8 points: the group is small enough, and the course structured, to allow substantial
discussion. I also encourage the raising of questions. One side of the blackboard will be available to write
questions at the beginning of class.
Please print out all assignments
Grading Criteria
A -- Work that goes above and beyond the instructor=s expectations -- is careful, thoughtful, original, thorough, all at once. Truly outstanding work
-- even for a Notre Dame student.
A- -- Very good work with most of the attributes of >A= work but either deficient in some technical aspect, in thoroughness and care or just not as
strikingly incisive, original or creative as >A= work. Still, excellent work.
B+ -- Better than good competent work, even for a Notre Dame student. Good competent work with aspects that really shine or creative original
work that needs more thoroughness to pin it down.
B -- Good competent work which meets all requirements the instructor could specify in advance. Reasonably thorough. Alternatively, work with
some excellent aspects that are balanced by serious deficiencies.
B- -- Almost up to the specifiable standards. Often characterized by some vagueness and signs of lack of effort or insufficient engagement with the
material. Sometimes the result of correctable misunderstanding. Talk to instructor.
C+ -- Below the specifiable standards for good work in an upper level course. Usually the result of lack of effort, attention and engagement,
sometimes of misunderstanding. Talk to instructor.
C -- Minimally passing work, showing serious misunderstanding or lack of effort and engagement. Talk to instructor.
C- -- Points to danger of failing. Talk to instructor before its too late.
D -- Very near failing. Talk to instructor before its too late.
F -- Failing work. Complete misunderstanding or lack of sufficient effort. Talk to instructor as soon as you can.
3
Schedule
week
topic
Readings
comment
wk 2 Sept 3,5
colonial medicine
Kraut intro, Blake, “Boston,” Mather, “Angel,”
Christianson, “New England”
wk 3 Sept 10
medicine and American
geography
Nash, ch. 1-2
no class Sept 12
wk 4 Sept 17,19
cultures of disease and care
Ulrich, “August 1787,” Abel, “Family Caregiving,” Rothman, section II, Sicherman,
“Neurasthenia”
Instructor will
be in library to
help choose
articles
wk 5 Sept 24, 26
Therapeutics and sectarianism
Rosenberg, “Therapeutics,” Whorton, ch. 1-4
article choice
due on the 24th
Wk 6 Oct 1-3
practice and profession
Lewis, Arrowsmith, ch. 1-18; Hertzler, ch,1-6,
Starr, “Consolidation,” Morantz-Sanchez,
“Connecting Link”
Wk 7 Oct 8,10
public health
Kraut, ch. 2-4, 9; Brieger, “Steven Smith,”
Rosenberg and Smith-Rosenberg, "Pietism,” Savitt,
“Black Health,” Lewis, Arrowsmith, 19-24
Wk 8 Oct 15, 17
hospitals and surgeons
Hertzler, ch. 7-10, Kraut ch. 8, Vogel, “Patrons,”
Lewis, Arrowsmith, c 25; Smith, Appendicitis,”
Atwater, “Of Grandes Dames”
Midterm out;
how many rxtn
papers have you
done?
Wk 9 Oct 29, 31
specialization and
compensation
Whorton, ch. 6-10; Tomes, “Private Side,”
D'Antonio, “Revisiting,” Numbers, “Third Party.”
midterm due,
Oct. 31
Wk 10 Nov 5, 7
Eugenics and race
Rothman, section 4, Kraut, ch. 5-6 Appel, “Duty to
Kill?”; Kenny, “Blood, Race, and Politics,” Brandt,
“Tuskegee”
Annotated
bibliographies
due Nov. 5.
Wk 11 n 12, 14
progressive reform and
occupational medicine: the
new public health
Nash 3, Kraut 7; Gabriel, “Mass-Producing the
Individual,” Grob, “Chronic Disease.”
Wk 12 Nov 19,
21
science, ethics, and (the
pharmaceutical) industry
Lewis, Arrowsmith ch. 26-40; Epstein, AIDs;
Rasmussen, “The Drug Industry,”
Tomes, “Great American Medicine Show
revisited.”
Wk 13 Nov 26,
28
environment and the new
epidemiology
Nash, ch. 4-5; Sellars, “The Dearth of the Clinic,”
Talley, Kushner, and Sterk, “Lung Cancer”
Wk 15 Dec 3,5
disease and lifestyle
wk 1 August
Hertzler, ch. 11-12; Whorton, ch. 11-12, conc;
Kraut, ch. 10; Elliott, “Amputees,” Fairchild,
“Polio Narratives,” Hirshbein, “Science, Gender,
and the Emergence of Depression”
4
Term paper due
Readings on Reserve
Abel, Emily. 1994. “Family Caregiving in the Nineteenth Century: Emily Hawley Gillespie and Sarah Gillespie, 1858-88.”
Bulletin of the History of Medicine 68: 573-99.
Appel, Jacob. 2004. “A Duty to Kill? A Duty to Die? Rethinking the Euthansia Controversy of 1906.” Bulletin of the History of
Medicine 78 : 610-34.
Atwater, Edward. 1990. “Of Grandes Dames, Surgeons, and Hospitals: Batavia, New York.” Journal of the History of Medicine
and Allied Sciences. 45(3):414-51.
Blake, John. 1952. “The Inoculation Controversy in Boston: 1721-1722.” New England Quarterly 25: 489-506.
Brieger, Gert. 1966. "Sanitary Reform in New York City: Stephen Smith and the Passage of the Metropolitan Health Bill."
Bulletin of the History of Medicine 40: 407-29.
Brandt, Allen. 1978. “Racism and Research: the Case of the Tuskegee Syphilis Study.” Hastings Center Report. 8:21-9.
Christianson, Eric. 1987. "Medicine in New England," in Ronald Numbers, ed., Medicine in the New World: New Spain, New
France, and New England. Knoxville: University of Tennessee Press.
D'Antonio, Patricia. 1999. “Revisiting and Rethinking the Rewriting of Nursing History.” Bulletin of the History of Medicine 73:
268-90.
Elliott, Carl. 2003. “Amputees by Choice,” chapter 9 in Better than Well: American Medicine meets the American Dream. New
York: Norton.
Epstein, Steven. 2004. "Democracy, Expertise, and Activism for AIDS Treatment," in Randall M. Packard, Peter J. Brown, Ruth
L. Berkelman, and Howard Frumkin, eds., Emerging Illnesses and Society: Negotiating the Agenda of Public Health. Baltimore:
Johns Hopkins University Press, 102-20.
Fairchild, Amy. 2001. “The Polio Narratives: Dialogues with FDR.” Bulletin of the History of Medicine 75: 488-534.
Gabriel, Joseph. 2005. “Mass-Producing the Individual: Mary C. Jarrett, Elmer E. Southard, and the Industrial Origins of
Psychiatric Social Work.” Bulletin of the History of Medicine 79: 430-58.
Grob, Gerald. 2002. “The Discovery of Chronic Illness,” chapter 9 in The Deadly Truth: A History of Disease in America.
Cambridge, MA: Harvard University Press.
Hirshbein, Laura. 2006. “Science, Gender, and the Emergence of Depression in American Psychiatry, 1952-1980.” Journal of the
History of Medicine and Allied Sciences 61: 187-216.
Kenny, Michael. 2006. “A Question of Blood, Race, and Politics.” Journal of the History of Medicine and Allied Sciences 61:
456-91.
Mather, Cotton. 1972. selections from The Angel of Bethesda ed. Gordon W. Jones. Barre MA: American Antiquarian Society.
Morantz-Sanchez, Regina. 1997. "The `Connecting Link': The Case for the Woman Doctor in 19th-Century America." Sickness
and Health in America, eds. Ronald Numbers and Judith Leavitt, 213-24. 3rd ed. Madison: University of Wisconsin Press .
Numbers, Ronald. 1979. "The Third Party: Health Insurance in America." The Therapeutic Revolution: Essays in the Social
History of American Medicine, eds. Morris Vogel, and Charles E. Rosenberg, 177-200. Philadelphia: University of Pennsylvania
Press.
Rasmussen, Nicholas. 2005. “The Drug Industry and Clinical Research in Interwar America.” Bulletin of the History of Medicine
79, no. 1: 50-80.
Rosenberg, C and Smith-Rosenberg, C. 1968. "Pietism and the Origins of the American Public Health Movement: A Note on
5
John H. Griscom and Robert M. Hartley," Journal of the History of Medicine and Allied Sciences 23: 15-35.
Rosenberg, Charles. 1979. “The Therapeutic Revolution: Medicine, Meaning, and Social Change in Nineteenth Century
America.” Rosenberg, Charles and Vogel, Morris, eds. The Therapeutic Revolution: Essays in the Social History of American
Medicine. Philadelphia: University of Pennsylvania Press.
Savitt, Todd. 1989. "Black Health on the Plantation: Masters, Slaves, and Physicians." Science and Medicine in the Old South,
eds. Ronald Numbers, and Todd Savitt, 327-55. Baton Rouge: Louisiana State University Press.
Sellars, Christopher. 2003. “The Dearth of the Clinic: Lead, Air, and Agency in Twentieth-Century America.” Journal of the
History of Medicine and Allied Sciences 58: 255-91.
Sicherman, Barbara. 1977. “The Uses of a Diagnosis: Doctors, Patients, and Neurasthenia.” Journal of the History of Medicine
and Allied Sciences 32: 33-54.
Smith, Dale. 1996. “Appendicitis, Appendectomy, and the Surgeon.” Bulletin of the History of Medicine 70, no. 3: 414-41.
Starr, Paul. 1982. “The Consolidation of Professional Authority, 1850-1930,” chapter 3 in The Social Transformation of
American Medicine. New York: Basic Books.
Talley, Colin, Howard Kushner, and Claire Sterk. 2004. “Lung Cancer, Chronic Disease Epidemiology, and Medicine, 19481964.” Journal of the History of Medicine and Allied Sciences 59: 329-74.
Tomes, Nancy. 1990. "The Private Side of Public Health: Sanitary Science, Hygiene, and the Germ Theory, 1870-1900."
Bulletin of the History of Medicine 64: 509-39.
Tomes, Nancy . 2005. “The Great American Medicine Show revisited.” Bulletin of the History of Medicine 79: 627-63.
Ulrich, Laurel. 1991. “August 1787,” chapter 1 in A Midwife's Tale: The Life of Martha Ballard based on her Diary, 1785-1812.
New York: Vintage.
Vogel, Morris. "Patrons, Practitioners, and Patients: The Voluntary Hospital in Mid-Victorian Boston." Victorian America, ed.
Daniel Walker Howe, 121-38. Philadelphia: University of Pennsylvania Press, 1976.
Journals and other works to consult in the Notre Dame Library
Topics
Early American Medicine
Cotton Mather, The Angel of Bethesda R 128.7 M
Daniel Drake, Principal Diseases of the Interior Valley, as they appear in the Caucasian, African, Indian, and Esquimaux
Varieties of its Population RA 802 D772
Matthew Carey, A Short Account of the Malignant Fever latterly prevalent in Philadelphia 1794
Medical Sectarianism
The Homeopathic Envoy (1911-15), RX 1 H 754
Hering=s Condensed Materia Medica, 1877, RX 601 H424c 1877
Alkaloidal Clinic R 11 C616, 1903-5
The Sanitary Revolution
Massachusetts Sanitary Commission, Report of a General Plan for the Promotion of Public and Personal Health, 1850, RA 84
.H3 1972
Citizens= Association of New York, The Sanitary Condition of the City (1866) RA 448 N5 C6 1970
Civil War B The Sanitary Commission Bulletin, #1-40 (E 631 .A1)
Self-Medication and Pharmacy
American Druggist RS 1 Am34 [1876]
6
American Druggist=s Circular and Chemical Gazette RS1 D82 [1860]
Merck=s Report RS 1 M537 [1908]
Journal of the American Pharmaceutical Association, RS 1 Am 35, 1912-
Social Diseases and Eugenics
Mental Hygiene RA 790 A1 M51), beg, v. 1 (1917)
Journal of Venereal Diseases Information, RC 201 J86, 1923Journal of Criminal Psychopathology (later J of Clinical Psychopathology and then Clinical and Experimental
Psychopathology) 1939- RC 321 J826
Public Health in the Progressive Era: the nation
Annual Report of the Surgeon General RA 11 B 153, beginning c. 1905
Public Health Reports RA 11 B 15, beginning c. 1910
Public Health in the Progressive Era: the State and the City
Department of Health of the City of Chicago, Reports for 1911-1918, RA 53 C 432r
Indiana State Board of Health Reports, from v. 25, 1906 RA 61 B1
Report of the Health Officer of the District of Columbia, 1882 - R 41 B11
Report of the Committee of Inquiry into the Dept of Health, Charities, and Bellevue and Allied Hospitals in the City of New
York, 1913. RA 122 N 489
American Medical Science
Journal of Medical Research, R11 J828, 1907Journal of Experimental Medicine, R 11 J827
American Journal of Medical Sciences, R 11 Am 34 1869-72
Public Health in the Progressive Era and after: the Profession and society
American Journal of Public Health, beginning v. 6, 1916 RA 421 Am 35
Hygea, R 441 H996, 1925- [generally a popular health journal]
American Journal of Hygiene. RA 421 Am 351, 1921-
Medicine and work
Alice Hamilton, Exploring the Dangerous Trades (1943), R 154 .H238 A3
AMA Archives of Industrial Hygiene and Occupational Medicine, RA 613 Ar 25
Financing Medicine and National Health
Reports on the Committee of the Cost of Medical Care, 1930s [R 152 C737]
US Congress. Senate. Committee on Labor. Hearings on a National Health Program, 1939 R 11 A3 1939b, pt. 1-3
US Congress. Senate. Committee on Education and Labor. National Health Program Hearings, 1946, R 11 A3 1946, pts 2-3
Clinical Sciences
American Journal of Clinical Medicine R11 C616, 1906
J. Of Clinical Investigation, R11 J 67, 1925-
.
Infectious and Tropical Diseases and the American Empire
Public Health and Marine Hospital Service, Bulletin of the Hygienic Laboratory RA 421 Un3, 1906Rockefeller Foundation, International Health Division, Annual Reports, RA 421 Am 351, 1935Journal of Infectious Diseases, R 11 J 8275, 1904
Journal of Immunology, QR 180 J 826
USPHS Yellow Fever Institute Bulletin, RC 211 A2 U55, 1902 -
Military Health and Society
US Veterans Administration Medical Bulletin, R11 U 58, 1925-1936
US Naval Medical Bulletin, R11 Un3mu, 1907-
The Medical Profession
7
Journal of the Student AMA R 11 AM 35, 1952-55
JAMA, R 11 J 826 1883-
Nutrition
Food Research, QR 115 F 739, 1936Journal of Nutrition, RM 214 J 826, 1928-
Others
Journal of Pediatrics, RJ 1 J46, 1946Annals of Surgery, RD 1 IN 8, 1893
Surgery, Gynecology, and Obstetrics, RD 1 Su 77, 1906 American Journal of Cancer Research, RC 261 J 82, 1916J. National Cancer Institute, RC 261 A1 Un 3, 1940-
Grading Checklist
Student ___________________________ Grade: _________
Commend
Suggestions
Thesis/focus well-defined__________
Good introduction/conclusion ________
Good analysis__________________
Good internal logic _______________
Vivid/effective examples __________
Use of specific detail ______________
Well-structured/organized _________
Clear/well-written ______________
Creative/lively style ______________
Fine command of topic _____________
Good use of primary sources__________
Good synthesis skills ____________
Well documented _________________
Creative, original analysis___________
Needs clearer focus ____________
Fix introduction/conclusion________
Need deeper analysis _____________
Check contradictions _____________
Give more examples ______________
Use more detail _________________
Rethink organization _____________
Fix awkward language ____________
Adjust tone or mood ______________
Fact/concept errors _____________
Rethink use of documents __________
Consult more sources _____________
Cite sources ___________________
Fix grammar/syntax _____________
OVERALL, YOUR GRADE WILL BE BASED ON
1. Persuasiveness of your HISTORICAL argument.
2. Quality of your writing
3. Careful, precise use of the assigned texts.
4. Thoughtfulness and originality
8
TEARSHEET
NAME
Major
Postgraduate plans
PLEASE ANSWER THE FOLLOWING
1. WHAT IS THE MOST IMPORTANT HISTORICAL QUESTION ABOUT MEDICINE IN
AMERICA?
2. What do you know of the American medical past? Try to list one thing under each heading
About medical institutions?
About medical procedures and therapies?
About medical professions?
About the health and disease experience of ordinary people in the past?
3. What is the most peculiar clinical encounter in which you=ve been involved?
4.
What is the most noteworthy event in your family’s medical past?
9
Health and Disease in America: the short version
empty continent
1. Religion and destiny; the power of Protestantism, the chosen, Medicine as religion; eternal life as goal
2. The vast importance of liberty: opposition to the state, to the professional, antistatism
3. Health as a means of destroying ethnicity; creating a single nation
Background: diseases in history
darwinian disease
small pox, syphilis and virgin soil epidemics
plague and the problem of zootics
fevers: continued and intermittent
consumption/gout/the stone/melancholia/dropsy
constitutional diseases
What do you know about the disease of the past
about the medical systems of the past
about the therapeutics of the past
about the medical institutions of the past
Principles
differential mortality
McKeown thesis
medical sectarianism
the centrality of quackery
centrality of commodification
social construction of disease and therapy
health as citizenship
caring on the frontier
the hospital as a total institution
eugneics and mental hygiene
films
ballard
road to wellville
tomorrow=s children
hospital
band played on
Varieties of medical encounter.
1. Ginseng?
Diets
Devices
House call?
Spiritual healing
Holy waters
emergency room
acupuncture
10
barb=s kildare
Describe the standard clinical encounter
What=s in the waiting room
kinds of chairs, plants,fish
11
http://www.who.int/whr/2000/en/report.htm
The great American medicine show : being an illustrated history of
hucksters, healers, health evangelists, and heroes from Plymouth Rock to
the present / David Armstrong and Elizabeth Metzger Armstrong.
Edition
1st ed.
Imprint
New York : Prentice Hall, c1991.
Descr.
viii, 292 p. : ill. ; 28 cm.
Location
Hesburgh Library General Collection R 730 .A75 1991 Regular Loan
12