The elusive role of scientific medicine in mortality decline: diphtheria in nineteenth- and early twentieth-century Philadelphia

The designation of the Klebs-Loeffler bacillus as the cause of diphtheria in the early 1890s and the subsequent development of the antitoxin treatment in the years immediately following were at the time and continue to be viewed as triumphs of scientific medicine. I focus on these two developments to illustrate the problems that arise in attempting to answer the questions regarding the role that changes in medical practice--in this case, the use of antitoxin as a cure--played in lowering death rates at the time. Changes in diagnostic techniques, the selection of cases to be included, and ultimately the agendas of the persons constructing them affected the numerators and denominators of these rates. The data suggest that the antitoxin had some effect on already declining diphtheria death rates, but because of changes in understandings of the disease and contemporaries' presentation of the data, the size of that effect and its role in mortality decline more generally elude us. Our analysis of the past depends on numbers that reflect not only changing treatments but also changing understandings of disease at the end of the nineteenth century.     

The archaeology of place

It is suggested that if archaeologists are to be successful in understanding the organization of past cultural systems they must understand the organizational relationships among places which were differentially used during the operation of past systems. This point is illustrated by observations made among the Nunamiut Eskimo. Against this background it is demonstrated that the two most common forms of archaeological systematics, “assemblage”- versus “type”-based systematics, are not appropriate for the study of places. In the latter case, it is not possible to analyze places as such, while one cannot see places with different “content” as part of a single system in the former. It is concluded that current archaeological systematics are totally inappropriate for studying past systems of adaptation and their evolutionary modification.     

旧金山之美

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William Pulteney Alison, the Scottish philosophy, and the making of a political medicine

This article considers the public health and social-reform agitations of Dr. William Pulteney Alison (1790-1858), professor of medicine at Edinburgh University and leader of the Scottish medical profession, in the context of Scottish moral philosophy. Throughout his career, Alison reflected on what has come to be recognized as a central problem of social medicine: where did its domain end? At what point did the medical mission of identifying and eliminating factors that harm health pass into a non-medical domain-the provinces of political economy, individual liberty, participatory politics, or acceptance of nature's dictates? On these issues Alison was an expansionist, relentlessly pushing back the borders of medicine. Drawing on Alison's writings on such disparate topics as the philosophy of mind, the epidemiology of infectious diseases, and modes of agrarian organization, the article argues that the trajectory of much of Alison's work was to discover the structural implications of a comprehensive biological reading of human capacity and behavior. It is therefore appropriate to see him as a promulgator of a "political medicine," which he presented as a critical alternative to the classical political economy of the Scottish Malthusians. The article concludes by suggesting that Alison's work (and influence) have been under-recognized and remain pertinent to modern social epidemiology, public health, and medicine more broadly.     

The first career of William Alexander Hammond

Neurology in its modern sense was first studied in the well-known neurological institutions of France and England. In America, however, this new field of medicine was developed by a physician in a private practice, Dr. William Alexander Hammond. This article addresses the question how Hammond was able to limit his practice to neurology. It is argued that Hammond was a famous military physician before becoming the first practitioner of clinical neurology in America. This fame translated into a large referral base.     

The disciplining of scientific communities

Abstract

Amidst ongoing concern with training students in the skills and knowledge necessary to contribute towards a knowledge-intensive economy, we explore how particular ‘epistemic subjects’ are produced within specific epistemic communities. We examine how social studies of science have probed the ‘disciplining’ practices that constitute scientific knowledge production, but have tended to overlook how students participate in, and become members of, epistemic communities. We propose that training contexts provide a window onto the disciplining processes through which scientific fields and their practitioners are co-produced. We offer an empirical example of an emerging scientific field that is working to establish community boundaries through the recruitment and training of university students. We explore how newcomers’ practices, values and identities are disciplined through participation in this nascent community whilst remaining open to negotiation and resistance. The conclusion calls for more scholarly attention to educational trajectories as processes through which disciplines and their disciples are produced.     

The William Bruntons and their Buddle

Abstract

The Brunton buddle was a common lead ore separation device in the Northern Dales, supposedly invented by William Brunton at Allendale in Northumberland in 1847. This article outlines the biographies of the two William Bruntons and corrects the supposition about the place and date of invention of the buddle. The buddle is described using William Brunton's words and its method of working outlined. Reference is made to some results of recent calculations which illuminate the range of operation of the buddle. The whole is stimulated by Durham County Council's restoration programme for the Brunton buddle discovered at the Killhope Lead Mining Centre in Upper Weardale in Co Durham.     

The place of immigration in studies of geography and race

This paper argues that geographical research on immigration and geographical research on race and racism in the USA must be explicitly connected. Geographic processes such as globalization and urban development already link immigration with race and racism and suggest a need to conceptualize research agendas around immigration and race in relation to each other. Not only are racialized groups spatially connected in many neighbourhoods, cities and regions of the USA, but they are also linked through policies structured by the state at various scales and narratives produced about subordinated and racialized groups. In making this argument, I attempt to highlight work in geography, in related social sciences and in ethnic studies that demonstrates the necessity and usefulness of this approach. Geographers are uniquely positioned to illuminate how the construction of space, place and scale overlaps with the construction of racial-ethnic and immigrant identities and with racism itself. The paper argues that these and other research questions also benefit from linking race and immigration to gender, as some feminist geography and feminist studies have done. Likewise, ethnic studies offer a wealth of theoretical, methodological and empirical insight into linking immigration, race and racism in geographical work.     

The diary of William MacEwan: Part II

This instalment of the Diary describes the first stage of the journey from Quilimane to the interior, then the most convenient and practicable way to the British territory of Nyasaland, and the way by which both people and goods entered and left that country. This is all changed ; the route has been abandoned by the African Lakes Corporation, and Maruru, the first place where the Diarist saw African village life, probably no longer exists. When the Diary is completed, it is hoped to publish an article describing the country MacEwan saw as it is at the present day. Much has been done to improve the condition of the natives under British rule since then, but it is more difficult to ascertain their condition under the Portuguese ; much more, however, remains to be done. Transport, of course, has been improved out of all comparison, and it will be interesting to compare it with the means by which MacEwan entered the then Darkest Africa—improvement which has taken place well within a single lifetime.