Janet Golden

Society: Don't blame the mothers

Careless discussion of epigenetic research on how early life affects health across generations could harm women, warn Sarah S. Richardson and colleagues.

Photographs as data: An analysis of images from a mental hospital

This paper presents a case study in the use of photographs as data for historical sociological analysis. Based on a larger study of the first century of the social development of a large state mental hospital, the paper describes how a sample of 343 photographs was generated from the over 800 images the authors collected. We developed a layered analysis in which we examine the images in continuously greater depth and discuss the connections between each consecutive stratum of explanation. At the first level we produce anappraisal, a comparison of the images with the written historical record. The next level,inquiry, concentrates on themes in the collection as a whole. Finally, the concept of “thick description” guides the third level,interpretation, in which we examine in depth individual images. We present a series of images that correspond to each of these layers of analysis. A concluding section evaluates the costs and benefits of photographic evidence for the historical sociology of organizational change.

Nurse Irene Shea Studies the "Kenny Method" of Treatment of Infantile Paralysis, 1942-1943

In the 1940s nurses in the United States set out to learn the Kenny method of treating polio patients, which relied on hot packs and muscle strengthening exercises instead of the standard system of prolonged immobilization. Named for Sister Elizabeth Kenny, an Australian nurse who based herself in Minnesota during the 1940s and early 1950s, and viewed with suspicion by many physicians, nurses, and physical therapists, the treatment nonetheless proved effective. It changed the practice of polio nursing and the experiences of patients in the years before vaccine prevention largely eliminated paralytic polio.

A Startling New Chemotherapeutic Agent: Pediatric Infectious Disease and the Introduction of Sulfonamides at Baltimore's Sydenham Hospital

Using pediatric patient records from Baltimore’s Sydenham Hospital, this article explores the adoption of sulfa drugs in pediatrics. It discusses how clinicians dealt with questions of dosing and side effects and the impact of the sulfonamides on two diagnoses in children: meningococcal meningitis and pneumonia. The care of infants and children with infectious diseases made demands on physicians and nurses that differed from those facing clinicians treating adult patients. The article demonstrates the need to distinguish between pediatric and adult medical history. It suggests that the new therapeutics demanded more intense bedside care and enhanced laboratory facilities, and as a result paved the way for the adoption of penicillin. Finally, it argues that patient records and the published medical literature must be examined together in order to gain a full understanding of how transformations in medical practice and therapeutics occur.

Commentary: Observing the effects of alcohol abuse and pregnancy in the late 19th century

anomalies observed in 127 cases]. Ouest Med 1968;25: 476–82. 16 Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet 1973;2:999–1001. 17 Warren KR, Li TK. Genetic polymorphisms: impact on the risk of fetal alcohol spectrum disorders. Birth Defects Res A Clin Mol Teratol 2005;73:195–203. 18 Abel EL. An update on incidence of FAS: FAS is not an equal opportunity birth defect. Neurotoxicol Teratol 1995; 17:437–43. 19 May PA, Gossage JP, Kalberg WO et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev 2009;15: 176–92. 20 Elliott EJ, Payne J, Morris A, Haan E, Bower C. Fetal alcohol syndrome: a prospective national surveillance study. Arch Dis Child 2008;93:732–37. 21 May PA, Gossage JP, Marais AS et al. The epidemiology of fetal alcohol syndrome and partial FAS in a South African community. Drug Alcohol Depend 2007;88:259–71. 22 London L. The ‘dop’ system, alcohol abuse and social control amongst farm workers in South Africa: a public health challenge. Soc Sci Med 1999;48:1407–14. 23 Rose G. The Strategy of Preventive Medicine. Oxford: Oxford University Press, 1992.

“Remarkable Improvement”: Sulfa Drugs and Pediatric Meningococcal Meningitis, 1937–1949

Lauded as one of the greatest developments of 20th-century medicine, the “wonder drug” penicillin reshaped the treatment of infectious diseases and altered patterns of mortality. As a result, the breakthrough that preceded penicillin—the development of the sulfonamides—is often overlooked.1,–,3 Using records from Sydenham Hospital, a municipal communicable disease institution in Baltimore, Maryland, in which nearly 75% of patients were children, we show the transformative role that sulfa drugs played in pediatric practice through a case study of meningococcal meningitis.4 Through the 19th and early 20th centuries, physicians observed patients ravaged by what they called “epidemic” or “cerebrospinal” meningitis. No matter how much mercury, opium, or arsenic they prescribed and no matter how many times they injected sterilizing agents into the dural space or drained infected cerebrospinal fluid via lumbar puncture, the disease proved fatal in nearly all cases.5,–,8 The first significant therapeutic breakthrough arrived when the Rockefeller Institutes Simon Flexner developed an intrathecally administered serum treatment. By the early 1920s, eminent Johns Hopkins pediatrician Kenneth Blackfan exulted that the serum lowered the mortality rate at the hospitals Harriett Lane Home from nearly 100% to 52%.9 Sydenham physicians used serum therapy with positive results. Their protocol, in which patients received meningococcus serum both intravenously and intrathecally, lowered the mortality rate to ∼30%.10 Although serum therapy saved Baltimore childrens lives, it proved challenging to administer, because it required numerous intravenous injections and lumbar punctures. It also … Address correspondence to Cynthia Connolly, PhD, RN, School of Nursing, University of Pennsylvania, 2017 Fagin Hall, Philadelphia, PA 19104. E-mail: cac1{at}nursing.upenn.edu

John Lincoln Bower: Photographing Philadelphia's Almshouse Hospital

Abstract Arthur Ames Bliss (1859–1913), in a memoir of his residency at Philadelphias municipal hospital lackley) in 1883 and 1884, recalled the finishing room for photographic work and the ‘many hours I spent there in developing my views of Blackley scenery, of its life and customs and queer inmates’. In one passage entitled ‘Out after game’ he offers a description of a sojourn on the grounds that is at once chilling and elegiac. A tripod under his arm, his holders loaded with plates, he sets out to capture on film the old outwarders (residents of the pauper rather than the medical wards) in their ‘ragged picturesqueness’. ‘Six seconds,’ he wrote, ‘and I have them forever’.1

American Women Physicians in World War I

The website of the American Medical Women’s Association (AMWA) presents an informative, well-researched, and well-illustrated online exhibit on American Women Physicians in World War I. The exhibit is largely biographical and incorporates material on and images of twelve physicians. Some of the physicians are well known to scholars, such as Esther Pohl Lovejoy and Rosalie Slaughter Morton. Others are less famous. Dr. Harriett Alleyne Rice, the first African American to graduate from Wellesley College, and a graduate of the Women’s Medical College of the New York Infirmary for Women and Children, worked at Hull House serving the working poor, before opening her own medical practice. During World War I she served at a hospital in France caring for wounded soldiers and was awarded the bronze medal of Reconnaissance Francaise, a medal of French gratitude, in 1919. Dr. Anna Tjomsland, an immigrant from Norway, earned her degrees at Cornell, became a citizen, and worked as an anesthetist at U.S. Army Base Hospital No. 1 during the war, publishing a history of the unit in 1941 in Bellevue in France. The opening description of the exhibit informs readers that the Army Surgeon General rejected women physicians from the Medical Corps, but accepted nurses, forcing women doctors who wanted to serve to find their way overseas by other means. The core of the exhibit text then provides descriptions of numerous aspects of their war service in French Military Hospitals, the Women’s Oversea Hospital, the American Red Cross, and the American Women’s Hospital Service, among other postings. Scholars can follow the links in the text to the papers of individual physicians, books, and exhibits. Dr. Tjomsland’s book is one such link; the family history website of Dr. Rice is another. The website also includes a bibliography of primary and secondary sources. For those teaching American women’s history, history of medicine, and military history, the website will provide useful information and images as well as links to some excellent materials for students to analyze in class or short assignments. The Doctor or Doctress website of the Drexel University College of Medicine Legacy Center is one such link, and it is designed for use by students and teachers. In short, as an information source and host to useful links, this is a terrific exhibition website. Perhaps it will get better. The annual meeting of the American Medical Women’s Physician in 2017 will host a short documentary about women physicians’ war efforts at the National World War I Museum and Memorial. Hopefully, it will end up on the AMWA site.

Modern Medical Science and the Divine Providence of God: Rethinking the Place of Religion in Postwar U.S. Medical History

Drawing on a large cache of letters to John and Frances Gunther after the death of their son as well as memoirs and fiction by bereaved parents, this essay challenges the assumptions of secularization that infuse histories of twentieth-century American medicine. Many parents who experienced the death of children during the postwar period relied heavily on religion to help make sense of the tragedies medicine could not prevent. Parental accounts included expression of belief in divine intervention and the power of prayer, gratitude for God’s role in minimizing suffering, confidence in the existence of an afterlife, and acceptance of the will of God. Historians seeking to understand how parents and families understood both the delivery of medical care and the cultural authority of medical science must integrate an understanding of religious experiences and faith into their work.

The United States Children’s Bureau and Pediatric Medicine: A Retrospective Analysis

* Abbreviations: AAP — : American Academy of Pediatrics AMA — : American Medical Association EMIC — : Emergency Maternity and Infant Care IMR — : infant mortality rate USCB — : United States Children’s Bureau This year marks the centennial of the founding of the United States Children’s Bureau. A remarkable agency, directed by women in its early years, the bureau played a major role in studying and lowering infant mortality. Medical historians Janet Golden and Jeffrey Brosco provide an overview of its history, and of why it had an oftentimes stormy relationship with organized medicine, sometimes including pediatrics. —Jeffrey P. Baker, MD, PhD Section Editor, Historical Perspectives This year, 2012, marks the 100th anniversary of the United States Childrens Bureau, a federal agency founded with the support of pediatricians. Its history, including its conflicts with organized medicine and its path-breaking work in promoting child health, is helpful in understanding the new focus in pediatrics on the social determinants of health from a life-course perspective. A December 1912 New York Times article headlined “150,000 Babies May Be Saved Each Year” announced an attack on infant mortality by the newly created United States Children’s Bureau (USCB).1 Fought for by progressive reformers, promoted by President Theodore Roosevelt, supported by pediatricians, and signed into law by President William Howard Taft, the USCB is now celebrating its 100th anniversary. Its mission, to investigate and report on all matters pertaining to children and child life, marked a bold step for the federal government, which until that time left health policy to state and local governments. The USCB was created when infant deaths were common, the promise of … Address correspondence to Janet Golden, PhD, Rutgers University, Camden, 311 North 5th St, Camden, NJ 08102. E-mail: jgolden{at}camden.rutgers.edu