Intimate Climates

Notes, Summaries & Reviews, Thesis Research

Vladimir Jankovic, “Intimate Climates: From Skins to Streets, Soirees to Societies,” in Intimate Universality: Local and Global Themes in the History of Weather and Climate eds. James Fleming, Vladimir Jankovic, and Deborah Coen, 1-34 (Sagamore Beach: Science History Publications, 2006).

In this chapter, Jankovic is interested in the dichotomy of the indoor/outdoor and in understandings (from literary and medical sources) of weather before the mass quantitative study of it really took off. He is particularly interested in indoor environments, an understudied aspect of weather — “intimate meteorologies.”

Selling Air

Notes, Summaries & Reviews, Thesis Research

John Beckerson and John K. Walton, “Selling Air: Marking the Intangible at British Resorts,” in Histories of Tourism: Representation, Identity, and Conflict ed. John K. Walton, 55-68 (Channel View Publications, 2005).

In this chapter, Beckerson and Walton analyze promotional material and medical/scientific opinion on air as a draw to different health resorts. They describe its link to the philosophy of climatic determinism, highlighting the different kinds of air publicists from different countries marketed as being salubrious. They seem to constrain their analysis to sea air and to England, which renders the chapter a bit less useful for me. The work is mostly descriptive.

The Politics of Medical Topography

Notes, Summaries & Reviews, Thesis Research

Harriet Deacon, “The Politics of Medical Topography: Seeking healthiness at the Cape during the nineteenth century,” 279-297, in Pathologies of Travel eds. R. Wrigley and G. Revill (Amsterdam: Rodopi, 2000).

Deacon focuses primarily upon the imperial, moral, and economic reasons that Cape Town faded as an important health resort spot in the 19th century. It was longer on an important trade route and was unable to compete with Mediterranean or, more significantly, European health resorts in society and status.

I didn’t find a whole lot useful here, mostly because the focus was not on the role that science played in the Cape’s downfall (and attempts to remain relevant). Deacon spends a lot of time fleshing out the moral implications that the developing city with few aristocratic or other high-ranking imperial officials seemed to have for some of those who commented on it. While its climate was originally held to be quite healthful, the discourse on climate and its deterministic role in the making of the individual increasingly cast doubt onto the location’s healthfulness. Deacon argues that this change was one explained better by imperialistic and economic motives than medical or scientific ones.

The Last Resort

Uncategorized

Vladimir Jankovic, “The Last Resort: A British Perspective on the Medical South, 1815-1870,” Journal of Intercultural Studies 27, no. 3 (2006): 271-298.

In this piece on British health travel to the Mediterranean, Jankovic aims to focus on the “…ways in which the medical reasoning and disease etiology impinged on the choice of resorts and regimens, and how such choice meshed with the broad understanding of the region based not only on the geographical and medical documents but also on its changing cultural stereotypes.” (272) He argues that medical opinion explained some aspects of health travel, but not all, as evidenced by the rapidly changing resort hotspots. Though Jankovic asserts that the “career of British climatotherapy… often drew upon the lay rather than scientific consensus and… often passed it verdicts in accordance to the Victorian environmental mores rather than observations, mortality tables or climatological statistics…,” he acknowledges the vital role that the “garb of impartiality and… use of scientific jargon…” played in legitimizing and differentiating different resorts. (272-73)

Water Cures and Science

Notes, Summaries & Reviews, Thesis Research

George Weisz, “Water Cures and Science: The french Academy of Medicine and Mineral Waters in the Nineteenth Century,” Bulletin of the History of Medicine 64, no. 3 (1990): 393-416.

In this piece, Weisz discusses institutional and individual attempts in nineteenth century France to place mineral waters and the therapies that involved them on a biomedical, statistical, and chemical foundation of therapeutic efficacy. He argues that the different way in which spa therapies are understood, utilized, and supported in Europe versus in North America is due to the medical and scientific fields’ support of hydrotherapy in the former, where it is largely absent in the latter.

Transactions of 7th Meeting of AR State Medical Society (1882)

Notes, Primary Sources, Thesis Research

Transactions of the State Medical Society of Arkansas at its Seventh Annual Session (Little Rock: Kellogg Printing Company, 1882).

List of Members of the Arkansas State Medical Society – total = 197, 2 from ES

Doctors who were practicing in ES:
J. O. Ducker — physician in Eureka Springs, AR — graduate of Jefferson Medical College, PA
M. Harrison — physician in Eureka Springs, AR — graduate of Louisville Medical College, KY (where Daniel Drake lectured for awhile!)

Breakdown of training by state:
NE Coast –
Maryland (8); New York (8); Pennsylvania (29); Maine (2)

SE Coast –
South Carolina (4); Virginia (3); Florida (1)

South –
Louisiana (20); Georgia (6)

Upper Midwest –
Michigan (2); Ohio (10); Iowa (3); Kentucky (38)

Lower Midwest –
Missouri (24); Arkansas (3); Tennessee (29)

Canada (1)

2 from L. I. H. Medical College, can’t figure out where that was located


Address on the Practice of Medicine, E. R. Duvall, Chairman of the Committee 

…by reason, treatment is more concise, more methodical, more scientific, results more satisfactory. All organs are systematically interrogated — in this manner the reflex and other manifestations, so often puzzling alike to patient and and medical attendant, are accounted for, and their significations placed in their proper relationship.” (50)

“To dose, dose, and dose again, originally significant of the erudition of our calling, and viewed with admiration by confrere and the laity, is now, through the agencies and by the influence of a progressive advancement all along the line, the least of the test by which fitness for responsible trust is to be determined.” (51)

Uses statistics in pro-Smallpox vaccine argument; discussion of English and German critiques of American vaccination practices, which proves they were reading literature from across the Atlantic? (52)


Report by committee appointed to investigate reforming (making more uniform, more rigorous) medical education; report by committee appointed to investigate and attempt to change medical legislation

Both pieces stress a need to monopolize & standardize medicine for the benefit of the people, who are being cheated by charlatans, quacks, and improperly trained doctors.


Piece on using blood to diagnose illness — the “Salisbury method,” from Dr. J. H. Salisbury (OH)

Advocates skilled and knowledgable use of microscopy to observe blood “corpuscules.” Pretty detailed account of what blood does when you add various concentrations of different substances.


Report on Bilious Fever by G. M. D. Cantrell of Hope, AR

Discusses weather, elevation of areas particularly affected by the disease
“…Klebs and Tomasi Crudeli, by their investigations, have discovered in the atmosphere of the Potine marshes peculiar rod-like bodies, which they have called bacillus milariae, and which, by inoculation, they claim will produce paroxysms of intermittent fever.” (96)


“A Plea for Some Neglected Branches in Medicine” by George C. Hartt, Little Rock, AR

Argument for wider, broader training for doctors — “languages, mathematics, philosophy, and the sciences”

“All must acknowledge” that the acquirement of “some” languages — “especially French and German” — “cannot fail to afford both profit and pleasure, enabling him to understand the fresh utterances of foreign masters in their native tongue, and also many words and phrases which these languages are constantly contributing to medicine and to science.” (122)

Advocates knowledge of “geology,” so that physicians can be consulted in healthful locations for building stuff. Wonder why he doesn’t mention health resort therapeutics here? 😦

Argues that botany isn’t considered a real science because it is associated with mysticism (“astrology and alchymy,” “Thomsonian, or steam system, and botanic system…”) (127-128)

References Cuvier

 

Foucault: The Birth of the Clinic

Notes, Summaries & Reviews

Foucault’s is a history (if we can call it that) of discourse — of the way people talked about the body, particularly in its diseased state, and the way they’ve understood the doctor and the patient himself in relation to the disease.

« …commenter, c’est admettre par définition un excès du signifie sur le signifiant, un reste nécessairement non formule de la pensée que le langage a laisse dans l’ombre, résidu qui en est l’essence elle-même, poussée hors de son secret; mais commenter suppose aussi que ce non-parle dort dans la parole, et que, par une surabondance propre au signifiant, on peut en l’interrogeant faire parler un contenu qui n’était pas explicitement signifie. »

To comment on something is to assume that the ultimate meaning of what you’re getting at is more important than what you’re saying — that there’s something more, something left in the shadows of your words. I think Foucault is laying the foundations for the kind of work he will do in the rest of the book here, asserting that if we can read through the way that doctors talk about the body, the patient, the disease, and themselves in relation to it, we can understand at a deeper, more complex level how they saw and understood these concepts.

This is a history of reading between the lines, of seeing what was not explicitly stated and looking underneath for larger take-aways. I’m unsure how I feel about this, because it doesn’t seem to be based in anything tangible. It feels farfetched and difficult to substantiate, problems that Foucault does resolve, in my mind, in the remainder of the text.

I think it has the potential to be very powerful, though, and I love that Foucault states he is not arguing that this epistemic change in the late 18th century was doctors/scientists suddenly waking up and seeing what had really been there all along — rather, that a new kind of science (by which I mean what was considered scientific) emerged, and through its lenses, scientists and doctors saw different things. They were looking for different things.This way of looking at things, I think, is something a lot of historians of science don’t like. It’s the ultimate critique to the progress narrative and to positivism, to viewing the history of science, technology, and medicine as the story of how scientists eventually “got it right.”

Espaces et Classes

Primary (disease), secondary (disease + individual), tertiary (disease + individual + health infrastructure, or « l’ensemble des gestes par lesquels la maladie, dans une société, est cernée, médicalement investie, isolée, repartie dans des régions privilégiées et closes, ou distribuée a travers des milieux de guérison, aménages pour être favorables »). Big changes took place in the tertiary.

Une Conscience Politique

Begins by talking about epidemics, exploring how they were understood and why the concept of contagion was largely unimportant.

« On a discute beaucoup et longuement, et maintenant encore, pour savoir si les médecins du 18ieme siècle en avaient saisi la caractère contagieux, et s’ils avaient pose le problème de l’agent de leur transmission. Oiseuse question… »

Details growing « conscience collective » of medicine, as observations around France were being collectivized and disseminated through medical infrastructure.

« Le lieu où se forme le savoir, ce n’est plus ce jardin pathologique où Dieu avait distribue les espèces, c’est une conscience médicale généralisée, diffuse dans l’espace et dans le temps, ouverte et mobile, liée à chaque existence individuelle, mais bien à la vie collective de la nation, toujours éveillée sur le domaine indéfini où le mal trahit, sous ses aspects divers, sa grande forme massive. »

Discusses change in the doctor’s role being reinstituting an individual, idiosyncratic “normal” to, in the 19th century onwards, adhering to a common, popular normal as the standard for health.

Importance of the concept of healing the state — health as something the entire nation should be concerned about.

Le  Champ Libre

Account of the debates surround the reformation of medical education during the French Revolution;

Hospitals should be abolished; they shouldn’t be needed in the ideal state, because everyone will be healthy. They end up becoming the new “natural” place for disease, though, replacing the family.

Arguments over whether education/medical field should be regulated.

The Old Age of the Clinic

“Before it became a corpus of knowledge, the clinic was a universal relationship of mankind with itself; the age of absolute happiness for medicine. And the decline began when writing and secrecy were introduced, that is, the concentration of this knowledge in a privileged group, and the dissociation of the immediate relationship, which had neither obstacle nor limits between Gaze and Speech: what was known was no longer communicated to others but put to practical use once it had passed through esotericism of knowledge.”

Theory vs. seeing — to what extent do our theories dictate what we see? (“When Hippocrates had reduced medicine to a system, observation was abandoned and philosophy was introduced into medicine.”)

I’ve felt this way about learning history a lot. If I read so much theory, it’s going to change the way I do history. It’s going to change the way I read sources, the way that I understand them, and the way that I relate them to contemporaneous and modern-day situations and ideas. Is this less pure? Or merely substituting someone else’s bias for my own?

Details how the clinic is different from a hospital, one being that, while in a hospital, “one is dealing with individuals who might suffer from one disease or another,” in the clinic, “one is dealing with diseases that happen to be afflicting this or that patient: what is present is the disease itself, in the body that is appropriate to it, which is not that of the patient, but that of its truth.”

The Lesson of the Hospitals

Clinical hospitals became a space where “truth teaches itself… offers itself to the gaze of both the experienced observer and the naive apprentice; for both there is only one language…”

They made possible “the immediate communication of teaching within the concrete field of experience… effac[ing] dogmatic language as an essential stage in the transmission of truth.” (68)

Interesting, although I’d still argue there was a lot going on with medical language at this time. Someone didn’t just walk in and know how to talk about the body. The body still wasn’t speaking for itself.

“What makes medicine, thus understood, a corpus of knowledge of use to all citizens is its immediate relationship with nature; instead of being, like the old Faculty, the locus of an esoteric, bookish corpus of knowledge, the new school would be ‘the temple of nature’; there one would learn not what the old masters thought they knew, but that form of truth open to all that is manifested in everyday practice…” (70)

Signs and Cases

Begins by discussing similarities and differences between natural history and this new brand of medicine; continuing conversation distinguishing classificatory medicine and clinical medicine. Instead of just classifying everything by their differences and similarities, clinical medicine embodied “a gaze… not bound by the narrow grid of structure (form, arrangement, number, size), but that could and should grasp colors, variations, tiny anomalies… it must make it possible to outline chance sand risks; it was calculating.” (89)

Discusses signs and symptoms — actually kind of defines something for once — and the changing amount of space between what was a signifier and what was signified. Symptoms, instead of being a sign of something, become themselves part of the whole of the disease.

Fascinating discussion of the rising importance of statistics in medicine (WISH THERE WAS MORE SUBSTANTIAL EVIDENCE), which “gave the clinical field a new structure in which the individual in question was not so much a sick person as the endlessly reproducible pathological fact to be found in all patients suffering in a similar way; in which the plurality of observations was no longer simply a contradiction or confirmation, but a progressive, theoretically endless convergence…” (97) “The only normative observer is the totality of observers…’Several observers never see the same fact in an identical way, unless nature has really presented it to them in the same way.’” (102)

Seeing and Knowing

Difference between experimentation and observation

“The observing gaze manifests its virtues only in a double silence: the relative silence of theories, imaginings, and whatever serves as an obstacle to the sensible immediate; and the absolute silence of all language that is anterior to that of the visible.” (108)

The setting of the hospital is important, permitting “pathological events to be reduced to the homogenous; the hospital domain is no doubt not pure transparency to truth, but the refraction that is proper to make possible, through its constancy, the analysis of truth.” (110)

“…by saying what one sees, one integrates it spontaneously into knowledge…” (114)

This is a really important point for Foucault, I think. He’s writing about discourse as a way of knowing. How we put into language what we see is how we construct knowledge.

Long-winded analogy between disease and languages:

“Disease, like the word, is deprived of being, but, like the word, it is endowed with a configuration.” (119) – nominalistic (denies the existence of universals and abstract objects, but affirms the existence of general or abstract terms and predicates)

Open Up a Few Corpses

Argues that the histories of anatomy that posit dissection was not common until the mid-19th century are false, constructed to explain why pathological anatomy (the correlation of lesions with symptoms) wasn’t a thing earlier.

Historical narratives constructed as “retrospective justifications.”

“On the Frontier of the Empire of Chance”

Summaries & Reviews

Arwen Mohun, “On the Frontier of The Empire of Chance: Statistics, Accidents, and Risk in Industrializing America.” Science in Context 3 (2005): 337-357.

In “On the Frontier of The Empire of Chance,” author Arwen Mohun examines the rise in statistics and probabilistic thinking in the American vernacular context from the late nineteenth through the early twentieth centuries. Through the lens of a cultural historian of technology, Mohun takes a closer look at how the industrial-era quantification of risk altered the way people understood it; she asks why and how this transformation took place, and then delves into how these understandings were shaped and used in order to mold individual behavior and enact widespread change. Mohun argues that the actors in her narrative existed on the periphery of the Empire of Chance. While experts, primarily located in European centers of statistical theorizing, formed the “epicenter” of the empire, those on the frontier employed statistics as a tool in social manipulation. Far from relegating popular audiences to a primarily observational, inert role, however, the author also acknowledges their agency in the story by explaining how their motivations affected their choices regarding risk and reward.

Obviously, Mohun’s work builds off of the book she references in her title — The Empire of Chance. Her piece is different from that of Gigerenzer et al., however, in that it addresses how the methodological and intellectual developments of professional statisticians found their way into popular understandings of variability and the risks associated with it. This is reminiscent of Dr. Pandora’s assigned reading for her two weeks of 5990 at the beginning of the semester — Spectacular Nature and The Whale and the Supercomputer. Like Mohun’s work, Susan G. Davis looks at how ideas from the “top,” the professional scientists, filter down into the vernacular through institutions like SeaWorld. Mohun also looks at how institutions influence the way that popular audiences understand scientific theories, their consequences, and their uses. In contrast, Charles Wohlforth focuses on how non-professional ways of knowing had a major impact on the way scientists looked at and understood climate change in the arctic. Mohun mimics this approach when she includes in her analysis how the importance of individual experience affects the way that the average American understood and behaved in regards to risk-taking. When the approach involves popular science, both perspectives — top-down and bottom-up — are important for a holistic understanding of how science and vernacular audiences interact and influence one another, and in this regard, Mohun as clearly covered all of her bases.

Something I found particularly interesting in this piece was the discussion of the “pragmatic approach” to science that Mohun discusses primarily on pages 339 and 340. She argues that it was especially characteristic of American statisticians in the time period she covers, and cites as evidence their absence from histories of statistics. American statisticians worried less about developing sound theories and methods and more about applying their knowledge (no matter how unsound or theoretically dubious) to real-world problems. This embodied what I have come to understand as being a very Industrial-American ideal; the self-made, self-trained practitioner unconcerned with the useless, bookish knowledge so characteristic of their less hard-working, impractical European counterparts. I wonder if the different approaches caused animosity between American and European statisticians; they were obviously sharing ideas. What did these conversations look like, and how did they take place? Was it common for Americans to train abroad, or were universities in America training these frontiersmen of the Empire of Chance?

The Empire of Chance

Summaries & Reviews

The Empire of Chance: How Probability Changed Science and Everyday Life, Gerd Gigerenzer, Zeno Swijtink, Theodore Porter, Lorrain Daston, John Beatty, and Lorenz Krüger

            In their collaborative work, authors Gerd Gigerenzer, Zeno Swijtink, Theodore Porter, Lorrain Daston, John Beatty, and Lorenz Krüger attempt a cohesive study of how the science of statistics “transformed our ideas of nature, mind, and society.” (xiv) The first three chapters present a timeline on which the intellectual development of the science of statistics — with some consideration of its particular applications — is situated, the middle three deal with statistics in particular fields, and the last two concern broader implications of statistical analyses, ideologies, and methodologies. A central theme of the book is the idea that the science of statistics was both shaped and shaped by the sciences that it aided and that helped to develop it for their own explanatory and predictive goals. Professing to be the first of its kind, the survey offers detailed technical descriptions and examples that flesh out the mathematics and theories with which its actors are working.

The passages dealing with mid-nineteenth century debates surrounding the viability of statistical methods for physicians reminded me of S. Lochlann Jain’s criticisms of the same methods in her work, Malignant. Jain and her unlikely intellectual compatriots cite similar issues with the “numerical method” in medicine; it denies the complexity and uniqueness of the individual patient, aiming “not to cure the disease, but to cure the most possible out of a certain number” (Risueño d’Amador, 1836, 46). This results in the emotions Jain so skillfully articulates in her first-hand account as a cancer patient. Reduced to numbers, cancer sufferers are identified by the statistical methods their doctors use to diagnose and treat them. Equally concerning is the reliance of pharmaceutical companies on results from statistical studies to produce drugs that will target cancer on a broader scale, to the detriment of patients who would have benefitted from more personalized treatments. Perhaps these nineteenth century critics were not off base in their hesitancy to adopt such a dehumanizing method of handling disease.

Another bit I found particularly interesting was section 3.5, “Hybridization: the Silent Solution.” Having taken statistics and seen it in what I am now realizing was a surprising amount of my undergraduate science classes, I was struck by the fact that the statistical methods we learn as absolute and established are in fact far from it. Integral tenets to the type of statistics I was taught are, in actuality, theoretically at odds with one another, and yet, as the authors contend, “Statistics is treated as abstract truth, a monolithic logic of inductive inference.” (107) Because statistical methods are so widespread, I find it both surprising and alarming that these obvious impediments to its image as a well-established and unproblematic method of analysis are kept more or less hidden. It lead me into thinking about how oftentimes, when scientific disciplines are “successfully” mathematized, we deem them somehow more intelligible; they become more solid, their results more trust-worthy. Is this a valid logical jump to make, especially if statistics, one of the mathematical sciences that is employed most often, rests on shaky ground?