Midterm Review - History of Medicine and Health in America

Midterm review with all expected terms.

A significant number of significant terms in preparation for the midterm for History 3478

*** The definitions for each term are simple and do not discuss at length or in depth.

Shifting Burden of disease since 1900 — Rise of chronic illnesses in conjunction with the fall of acute and infectious diseases.

Cotton Mather on childbirth — Dangers of childbirth is in God’s hands.

Le Page du Pratz gets his eye treated — Effective Native American treatments for local diseases, but not foreign ones (e.g. smallpox, whooping cough, typhus). Le Page du Pratz praises a N.A. noninvasive eye treatment.

Columbian Exchange — Transfer of crops, livestock, diseases, and animals between the Old and New Worlds.

biohistory — The study of the biological roots of human social behavior including the outbreak of wars, economic growth and decline, forms of government, and the rise and fall of civilizations.

 “French Pox” — Another name for syphilis, refers to the believed French origin of the disease, funny enough the disease is also named after other countries (e.g. the “english disease” by the French).

Guns, Germs and Steel: main thesis — Geography, not race or culture, is the main factor determines which societies have become powerful or not. Geography allowed Eurasians the ability to domesticate a wide range of animals, which in turn lead to passing of diseases from livestock to humans. This in addition to increased population densities resulted in a larger assortment of diseases for the Old World to acclimate to compared to the New World.

Alan Kraut’s Four Themes — (1) Relationship among health, disease, and nativism, those prejudices and policies that express opposition to the foreign born. (2) Advances and perceived limitations of scientific medicine. (3) Institutional response of national, state, and local governments to both the qualitative and quantitative dimensions of immigration as it affected and was affected by public health considerations. (4) Immigrant and refugee response to differences between themselves and the native-born in matters of therapy, health care, disease prevention, and hygiene (all areas of public health).

Bynum’s Five “Medicines” — (Short) History of Medicine: bedside, library, hospital, community, and laboratory.

Hippocratic “holism” — Medical approach to the whole patient: social, economic, familial circumstances, and lifestyle.

Hippocratic “naturalism” — A philosophical viewpoint according to which everything arises from natural properties and causes.

Humors: Blood/Phlegm/Yellow Bile/Black Bile — Air (sanguine), Water (apathetic), Fire (Aggression), Earth (Melancholy) respectively. Four sides of Hot v Cold and Dry v Wet.

Six “non-naturals” — (1) Food and drink (2) Environment (3) Rest and wakefulness (4) Exercise (5) Evacuation of bodily residues (6) Emotions

Three Legacies of Hippocrates and Galen — (1) Humoralism (2) Botanical cures (3) Secular approach to disease

Three Institutions of Early Modern Medicine — (1) Hospitals (2) Universities (3) Doctors

Cotton Mather and William Douglas disagree — Mather promotes success of inoculation, Douglas deems practice illegal and potential detrimental to some.

Smallpox to smallpox — Same disease has changed since Smallpox was wipeout, new fears of bioterrorism.

Variolation (“inoculation”) & Vaccination — Inoculation = Taking live disease and introducing it in a controlled manner, Vaccination = Introducing a weaker form of the pathogen to trigger immunity response.

Colin Calloway on Native American population — Account of decimation of Native American population by new diseases, discusses exchange of medical knowledge and healing practices between natives and Europeans.

Miasma/Contagion/Contingent Contagion — Explanatory paradigms to explain epidemic diseases. Miasma theory = bad/rotting air spreads disease, contagion theory = disease spread from one to another, contingent contagion theory = disease miasmatic/contagious depending on circumstance.

Environment: climate/site/biological-immunological “portfolio”/built environment — Hospitals developed to allow for circulation of air, back to the miasma theory, control of temperature via climate control (AC, Heater) for suitable health.

Cholera: changes from 1832-1866 (Kraut)  — Early on 1832 Irish Catholicism blamed, 1849 Sanitarian theory for cleanliness and move to block Irish immigration, 1866 Disease seen as a social one of public health.

Irish-Catholic responses to culture of blame — Sensitive to charges of inferiority, forged alliance with Catholic Church to promote personal health and hygiene, push to assimilate into Americanism, development of Catholic hospital. 

St. Vincent’s Hospital — Catholic hospital opened in 1849 to treat all afflicted, staffed by Sisters of Charity, under the direction of Sister Mary Angela Hughes.

Metropolitan Board of Health — NYC Met. Board of Health first modern municipal public health authority in the United States, founded in 1866 by the New York City Common Council at suggestion by the New York Academy of Medicine.

Bynum, “Medicine in the Hospital”

• • French Medical Education (1789-1848) — Medical evolution to accompany French Revolution, focus on practical hands-on practice, new medical education at hospital, med grad to be trained in both medicine and surgery.
• • French Hospital Medicine (3 aspects) — physical diagnosis, pathological-clinical correlation, and use of large numbers of cases to elucidate diagnostic categories and to evaluate therapy.

Range of medical practitioners in early America — Wide range of practices from allopathic to Thomsonian medicine. 

Walter Channing, 1820 — Claims women as midwives are dangerous b/c character & education, obstetrics for male.

Martha Ballard, Midwife — Accounts of midwives role in America through account of midwife in New England.

Elizabeth Drinker — First hand account of mother calling multiple doctors for her daughter giving birth.

Benjamin Rush — Leading proponent of heroic medicine, advocated bloodletting and purging.

Wm Buchan’s Domestic Medicine — Popular manual of self medicine.

Therapeutic nihilism — A contention that curing people, or societies, of their ills by treatment is impossible. In medicine, it was connected to the idea that many "cures" do more harm than good, and that one should instead encourage the body to heal itself.

Jacob Bigelow — Most diseases are “Self limited diseases” that end in recovery/death regardless of physician.

Lunsford Yandell and what he learned — Kentucky physician that witnesses standard treatment fail, death of both mother and son to “utterly futile” treatment, demonstrates self esteem tied to health, medicine social.

Stimulation and vital power — Mid 19th Century, therapeutic revolution - push for medicine that will help body heal itself naturally.

Calomel/ laudanum/ lancet — Medical mercury, alcoholic solution with morphine, blade with sharp point used for blood letting.

Heroic medicine: why it persisted; why it faded — Persisted => (1) They “worked” - buying into placebo (2) Patients believed (3) Doctors believed - Used treatment on themselves (4) They worked = patient death - Using God as an excuse or time; Faded => (1) Nature’s vital power (2) Skepticism about rationalistic certainty (3) Patient demand and competition from other practitioners.

Specificity and universalism — Specificity => Different cure for each patient’s disease, patient specific disease; Universalism => One cure for single standardize disease

Homeopathy — A system of alternative medicine created in 1796 by Samuel Hahnemann, based on his doctrine of like cures like, a claim that a substance that causes the symptoms of a disease in healthy people would cure similar symptoms in sick people.

Calculus of suffering — Surgery before anesthesia a bloody affair, introduction of anesthesia comes into conflict with heroic medicine that views pain, balance struck between dangers of anesthesia and necessary pain for operation.

Savitt on race and dissection — Use of Blacks for anatomy via autopsy, poor & slaves necessary for hospital education, easy to use Blacks for anatomy studies because family is powerless to reject dissection, Dr. James Marion Sim uses Black females to experiment for cure to vesico-vaginal fistula.

Cartwright, Drapetomania, Dysaesthesia Aethiopis — Cartwright = racial theorist that proposed Blacks were slaves by nature, Drapetomania = mental illness that caused slaves to run away, Dysaesthesia Aethiopis = mental illness that caused laziness among slaves (esp. free Blacks). 

James Marion Sims — Uses Black females to experiment for cure to vesico-vaginal fistula, success.

Civil War and Public Health — Big state and volunteerism prepare ground work for increased public health.

US Sanitary Commission — A private relief agency created by federal legislation on June 18, 1861, to support sick and wounded soldiers of the U.S. Army during the American Civil War.

AMA Rise — 1847 AMA created, a united front of physicians, some reorganizing makes it a powerful entity that now begins to fight its competition by tightening requirements for med ed and license, Christian science+osteopathy+chiropractic still remain alive, monopolization of medical practice not complete, but good enough.

Dent v West Virginia 1888 — Court case that upheld the of the state medical examining board to deprive a poorly trained physician of their right to practice. 

Tension: Flexner Report and Rockefeller Foundation — Flexner Report: Too many uneducated doctors, standardized acreditdation and schools with hospitals needed, no sect divisions, Coed, Blacks segregated; Rockefeller Foundation: Rural areas suffering from decrease in # of doctors, Primarily b/c superior financial & professional advantage in cities, lowering medical examination standards will NOT help.

Bynum on Public Health Surveillance — For public health 3 dimensions to quantification of medicine: surveys, surveillance, and significance. Police functions of public health involve medical practitioners that have to report specific contagious diseases (e.g. T.B., smallpox, syphilis), forerunners of intelligence agencies. 

Ellis Island — Ellis Island, in Upper New York Bay, was the gateway for over 12 million immigrants to the United States as the nation's busiest immigrant inspection station from 1892 until 1954. The island was greatly expanded with land reclamation between 1892 and 1934. Before that, the much smaller original island was the site of Fort Gibson and later a naval magazine.

Trachoma — An infectious disease caused by bacterium Chlamydia trachomatis. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of the eyes, and possibly blindness.

Immigration Act of 1903 — Also called the Anarchist Exclusion Act, was a law of the United States regulating immigration. It codified previous immigration law, and added four inadmissible classes: anarchists, people with epilepsy, beggars, and importers of prostitutes.

Mary Mallon — Typhoid Mary, asymptomatic carrier of typhoid fever, battle for public health v human rights, detained and imprisoned.

Chick Gin — Chinese immigrant who died of bubonic plague that resulted in an epidemic in San Francisco Chinatown, resulting public health action of quarantine and cleansing drew large public attention. 

John Hunter, and common “cures” for disease in both races — Combined effort to combat T.B. for both Blacks and Whites, T.B. caused by bacteria that can be prevented by environmental reform and education.

Koch’s postulates — If disease is caused by microorganism: (1) The organism must be shown to be constantly present in characteristic form and arrangement in the diseased tissue (2) The organism which, from its behavior appears to be responsible for the disease, must be isolated and grown in pure culture (3) The pure culture must be shown to induce the disease experimentally.

Biomedical model — (1) Specific causality (2) Objective diagnosis (3) Universal (specific) treatment

Antisepsis/Lister — Spraying or treating area with cleanser to disinfect, Lister used carbolic acid (phenol).

Asepsis — Preventing infection by sterilizing hands, dressing, instruments, and other utensils to produce germ free environment.

Anesthesia — Anesthesia enables the painless performance of medical procedures that would cause severe or intolerable pain to an unanesthetized patient (Early modes available during Civil War, diethyl ether).

Rise of the Hospital — Medical specialization, increasing amount of equipment, prepared environments for operation, here to stay: sophisticated diagnosis, acute care, surgery.

Warren, “Northern Chills” GIGO? — Race-specific mortality, Health played a role in the nation’s split economies.

Authority and Rights (change over four periods) — Pre-19th Century: Local medical authority + moral authority; 19th Century: State authority, beginnings of federal authority + moral authority; Late 19th-Early 20th Century: Progressive, do-good, pretentiousness; New Deal Era (1930-1970s): Massive information of Federal Govt; Since 1970s: Downturn in faith in science, challenge authority of medical expertise

US Occupational Medicine lags behind Europe — Emphasis on business and lack of federal regulation against companies.

Assumption of Risk — Workers take job w/ assumption of possible occupational risk, company not responsible for damages.

Contributory Negligence — Failure of an injured plaintiff to act prudently, considered to be a contributory factor in the injury suffered, and sometimes reducing the amount recovered from the defendant.

Fellow Servant Rule — A common law doctrine that barred/reduced the amount of money an injured employee could recover against an employer if injury was caused solely by the negligence of a another fellow worker.

Role of company doctors and insurance cos. — Company doctors = Companies + management in response to increasing worker compensation. 

Phossy Jaw — Osteonecrosis of the jaw bone caused by excessive buildup of phosphorous, occupational hazard caused by phosphorous fumes used for match making.

Alice Hamilton — Progressive women that aimed to improve occupational health of workers through skillful maneuvering, failed to significantly change lead industry.

From Republican Motherhood to “Passionlessness” — Belief that women were to remain passionless with moral superiority, while men were like beasts, gave advantage of saying no to sex, problem: institutionalized prostitution. 

Hypersexual Females — Response to independent assertive women, medical classification of hyper sexual predator.

The growing menarche to marriage gap — Fertilization occurring earlier b/c better nutrition + marriage is encourage at a older age, menarche issue. 

Freud, Automobiles, and the working girl — Freudian view of criminalization as a result of sexual imbalances, cars allowing couples to taking dating away from wary eyes of the family, allows for necking.

Sexology: From Katherine Davis, to Kinsey, Masters and Johnson and Sher Hite — Long tradition, two periods of sexologists that emphasize “any goes as long as no one is hurt” and tries to provide science to back up that idea, grants social “permission” for sex.

The invention of Homosexuality — Defining abnormal through medicalization.

Comstock Law — Federal act passed by US Congress on March 3, 1873 that criminalized usage of USPS to send any of the following items: erotica, contraceptives, abortifacients, sex toys, personal letters alluding to sexual content, or any information regarding the above items.

Margaret Sanger — American birth control activist, opened first birth control clinic in US, developed organizations that resulted in Planned Parenthood Federation of America.

Oliver Wendell Holmes: “Three generations…” — Statement made by Judge Oliver Wendell Holmes presiding over the case of Buck v Bell that approved government sterilization of "undesirables." Often point at evidence of US eugenics movement.

Buck v Bell — Supreme Court ruling that state stature permitting compulsory sterilization of the unfit, including the intellectually disabled, “for protection of health and state” did NOT violate the 14th Amendment of the Constitution, seen as an endorsement of eugenics.

Twilight Sleep — Procedure developed to reduce pain during child birth and help in delivery, considered partially dangerous due to the specific combinations of anesthetic for operation needed, fears of inexperienced doctors using it. 

Abortion: Three categories (1) Therapeutic (2) Elective (3) Eugenic Who Decides: 

Quickening — child movement, women or parent decides

State Laws (pre-1880) — Abortion illegal once quickening begins, later AMA effort to ban abortion

Under Roe v. Wade — State decides

Leslie Reagan’s periodization:

1880-1930: “An Open Secret” — Abortion is “banned,” but still flourishes due to needs.

1930-1940: Depression brings abortion into open — Bad economy brings abortion back into the open.

1940-1973: increasing restrictions on abortion — Good times, have kids.

1950s-1973: (overlap) the fight to legalize abortion — Rights and freedoms!

Roe v Wade — Right to privacy under the Due Process Clause of the 14th Amendment extended to a woman's decision to have an abortion, but that this right must be balanced against the state's two legitimate interests in regulating abortions: protecting women's health and protecting the potentiality of human life.

Hyde Amendment of 1976 — A legislative provision barring the use of certain federal funds to pay for abortion except to save the life of the mother, or if the pregnancy arises from incest or rape.

Webster v Reproductive Health Services (1989) —  United States Supreme Court decision on upholding a Missouri law that imposed restrictions on the use of state funds, facilities, and employees in performing, assisting with, or counseling on abortions.