20 years of social history of medicine

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SocialHistoryofMedicineVol.20,No.3pp.435–440EditorialTwentyYearsofSocialHistoryofMedicineThefirstissueofSocialHistoryofMedicinewaspublishedin1988.Thefirsteditorialdefendedthedecisiontocreateanewacademicjournal‘inaclimateofacademic1retrenchmentandseverelytrimmedlibrarybudgets...’.Tenyearslater,theeditorialthatmarkedthetenthanniversarynotedthatdespite‘severecutbacksinhigheredu-cation,whichdigdeeplyintolibrarybudgetsandwhichhaveledtoadifficultclimateforacademicsandstudents’,thejournalhadgrownstronger.Thiswasevidencedby2risingsubscriptionsandanever-improvingqualityofscholarlycontributions.Now,onourtwentiethanniversary,abroadlysimilarscenariomaybedetected.Despitesuccessivewavesofsenioracademicretirements,universitiescontinuewiththecost-savingtacticofemployingpart-timeornon-permanentteachers.Simultaneously,librarybudgetscon-tinuetolanguish.ButSocialHistoryofMedicineremainsrobustandcontinuestoreceiveanoutstandingsupplyoforiginalscholarship.Membershipandsubscriptionscon-tinuetorise.Theon-lineversionofthejournalanditsarchiveshavegeneratedintriguingstatisticalinformationontherelativepopularityofdifferenttopicsovertheyears.TwentyyearsofscholarshiphavegiventheSocietyfortheSocialHistoryofMedicineandthedisciplineitrepresentsmuchtocelebrate,contemplateandcite.Thejournalhaspioneerednewapproachestomedicalhistoryandstimulatedlivelydebateabouthowbesttounderstandhistoricalchangeinmorbidityandmortalityrates,thedevelop-mentofmedicalpracticesandinstitutions,thehealthofpatientsandpopulations,andtherelationshipofthesetopicstosocial,political,economicandculturalconcerns.AsIlanaLo¨wypointsoutinhersurveyoftwentyyearsofcontributionstoSocialHistoryofMedicine(‘TheSocialHistoryofMedicine:BeyondtheLocal’),certainthemesandscholarlyinterestshaveendured.Themuchcitedfirstarticleinthefirstissueofthejournal,SimonSzreter’scritiqueofThomasMcKeown’sthesisonthedeclineinmortalityinBritainfrom1850–1914,isanexcellentexample.FurtherdiscussionofthisvenerabledebateiscarriedinthisanniversaryissuebyRobertWoods.In‘MedicalandDemographicHistory:Inseparable?’,WoodscitesSocialHistoryofMedicineauthorssuchasMaryDobson,SumitGuha,BernardHarris,JamesRileyandothers.Heurgesthathealthimpactassessment(HIA)methodsbeusedintheexaminationoftopics,suchastheeffectofmedicalinterventiononlifechances.Woodsalsounderlinestheimportanceofan‘evidenced-basedmedicalhistory’tointegratequantitativeandqualitativeresearchmethodologies.Akeymessageisthat,whileeachapproachhasitsmerits,bothrequire‘criticalandscepticalinterpretation’.Issuesofevidenceandinterpretationrelatingtothereassessmentofthe‘epidemiologictransition’andthetollofinfectiousdiseasesonthehealthofthepopulationofVictorian1BryderandSmith1988,p.v.2FeeandWeindling1997,p.1.&TheAuthor2007.PublishedbyOxfordUniversityPressonbehalfoftheSocietyfortheSocialHistoryofMedicine.Allrightsreserved.DOI10.1093/shm/hkm109AdvanceAccesspublished13November2007 436BrianDolanBritainareaddressedbyGrahamMooneyinhiscontributiontoourrecentlyinaugurated‘SecondOpinions’section(‘InfectiousDiseasesandEpidemiologicTransitioninVictorianBritain?Definitely’).ReplyingtothefirstofthesearticlesbyFlurinCondrauandMick3Worboys,Mooneychallengesthehistoricalnosologywhichtheseauthorsusedtodeter-minewhatconstitutesaninfectiousdisease.Mooneyconcludesthatthethornyissuesofclassificationhaveprofoundrepercussionsfortheinterpretationofthecourseandpatternofmortalitydeclineinthenineteenthcentury.Perhapsnolargerchallengetonosologiesorclassificationsystemspresentsitselfthaninthequesttoidentifytheoriginsofadisease.Often,avarietyofcompetingstoriesseektoestablishasingleexpla-natoryframeworkthatpurportstoencompassthetotalhistoryofadisease.But,asAnneKveimLieexploresin‘OriginStoriesandtheNorwegianRadesyge’,originstoriesare‘butoneelementinthe“surfaceofemergence”[touseFoucault’sarchaeologicalmetaphor]thatallowssomethingtobecalledadisease’.AnotherkeytopicrelatingtotheMcKeowniteparadigmdrawsonscholarshipinvesti-gatinglong-termchangesinmaternalandinfantmortality.Thistheme,togetherwithrelatedresearchonthetrainingofandattitudestowardsmidwives,hasalsobeenrefinedovertheyearsinSocialHistoryofMedicine,intheformofcasestudiesfrom4Europe,America,AustraliaandAsia.Inouranniversaryissue,VincentDeBrouwere’s‘TheComparativeStudyofMaternalMortalityoverTime:TheRoleoftheProfessionalisa-tionofChildbirth’drawsontheworkofscholarsalreadywellknowntoourreaders,includingIrvineLoudon,HilaryMarland,Anne-MarieRaffertyandUlfHo¨gberg.ThematicdevelopmenthasbeenaconstantinSocialHistoryofMedicine.Thustheedi-torialintroductiontothefirstissuemadeacommitmentto‘anacademicstudyofallaspectsofthesocialhistoryofmedicine...havingreferencetothepatientaswellasthepractitionerandtohealthaswellasdisease’.Noinnovationhasbeenmoreinfluentialthanthepromotionofthe‘patient’spointofview’bywriterssuchasDavidArmstrong,EdwardShorter,LucindaBeier,DorothyPorterandRoyPorter.AsFlurinCondrauremindsusinhisessayinourtwentiethanniversaryissue,‘ThePatient’sViewMeetstheClinicalGaze’,thisapproachhelpedtosetanewagendaofresearch‘frombelow’whileatthesametimedepictingadialecticbetweenproducersandconsumersinthemedicalmarketplace.Condraucontendsthatthemethodologyhasyettoreachfullmaturity.Inhercontributionalreadymentionedabove,IlanaLo¨wyadvocatesyetanotherbroad-eningofthefield.SocialHistoryofMedicinehaslongpublishedarticleswithawidegeo-graphical,chronologicalandthematicspread.However,themajorityhavetendedtobecase-basedwithafocusonthelocal,regionalornational.ButLo¨wycontendsthatthehistoryofmedicineconstitutesagrandnarrativeinvolvingtrans-nationaldevelopmentandtheinternationalcirculationofpeople,ideas,toolsandtechniques.Sheremindsusoftheimportanceoftakingabroadhistoricalviewoftheemergenceofmodernscienceandmedicine,athemereinforcedrecentlywiththeappearanceofHalCook’sanalysisofthescientificrevolutionviewedwithinthehistoryofglobaleconomic3CondrauandWorboys2007.4Forexample,onmaternalmortality:Loudon1988;Loudon1991;Lang2005;Earner-Byrne2006.Onmid-wifery:Harley1990;Fox1993;Woolcock,ThearleandSaunders1997;Mcintosh1998;Thomas2003;Tuchman2005;Homei2006. Editorial4375imperialismoftheDutchRepublicduringitsgoldenageof1581–1795.Bycomparinganumberofarticlesonpopulartopicssuchasthehistoryofpublichealthand6mortality,professionalisationandoccupationalhealth,Lo¨wyassessesthebenefitsofdrawingonlocalstudiesasabasisforarrivingatconvincingcomparativeinterpretation.Shenotesthat‘Trans-nationalcomparisonsmaydisplayunexpecteddifferencesand/orsurprisingsimilarities;questionsinitiallystudiedinonecontextcanacquireadifferentmeaningwhentransposedtoanothersituation;ajuxtapositionofdevelopmentsinseveralsitescanprovideinformationimpossibletoobtainfromsingle-sitestudies.’Lo¨wy’scallforthemoreactivepromotionofcomparativehistoricalanalysismakesanappeallinkedtoearlierpleastomovebeyondtheclosedcircleofwesternhistoryofmedi-cine.Inherreviewof‘TheMissionofSocialHistoryofMedicine’inthe1995jubileecel-ebrationsofthefoundationoftheSociety,DorothyPorteridentifiednewdirectionsincluding‘thesocial,economic,andenvironmentalinfluencesonhealth,involvingtheexaminationsofhowmedicinehascontributedtogenerallevelsofthehealthofpopu-lations,exploringthereasonsforpatternsofprofessionalpractice,andthediscussion7offorcesdrivingtheevolutionofpublichealthservices’.Whetherinhistoriesofhealthpolicy,complementaryandalternativemedicine,orthepoliticsofmedicalpractice,therehasbeenconsiderabledevelopmentinthesefields.Indeed,thejournalhasmovedwellbeyondthethreeareaswhichJohnPickstoneidentifiedinhissemi-autobiographicalnarrativeofthehistoryofthediscipline:‘socialmedicine,medicalsociology,andthe8historyofpublichealth’.Oneareainparticularthathasdevelopedduringthelast20yearsandwhichembracesthemovetowardthecomparativeandtheglobalhasbeenthehistoryofcolonialmedi-cine.Tenyearsago,ShulaMarks,thenPresidentoftheSocietyfortheSocialHistoryofMedicineandcommentatorattheSociety’s1996conference‘MedicineandtheColonies’,notedthattheoreticalandmethodologicalinnovationsinourdiscipline,coupledwithglobalconsciousnessoftheriseofnewinfectiousdiseasessuchasAIDSandthere-emergenceofoldonessuchastuberculosisandchloroquine-resistant9malaria,hadprovidedanimpetusforhistoricalworkinthesefields.Inthepresentanni-versaryissue,WaltraudErnstfurtherreflectsonthehistoryofcolonialmedicinein‘BeyondEastandWest:FromtheHistoryofColonialMedicinetoaSocialHistoryofMedi-cine(s)inSouthAsia’.Shenotesthatinterdisciplinarypost-colonialandpost-moderntheoryhaveredirectedtheresearchfocusfromwesternhegemonicmedicalpracticetoamultiplicityofindigenousmedicinesandtheremappingofsocial,politicalandecon-omicnetworksthatconnect‘localities’to‘globalities’.Ernstseesthefutureofthehistoryofcolonialmedicine(HOCM)intermsoftheexaminationofdiverseculturalsources,drawingonevermorediverseanalyticmethods,andrenderingitevermoreinter-disciplinaryandmoreakintosocialhistory.5Cook2007.6BernardHarris’sarticle‘PublicHealth,Nutrition,andtheDeclineofMortality:TheMcKeownThesisRevisited’(Harris2004)wasthenumberone-rankeddownloadedPDFin2005and2006.7Porter1995,p.349.8Pickstone2005,p.316.9Marks1997. 438BrianDolanDoesthisconceptualshift,whichinvitesintegrationwiththeworkofcolleaguesinmedicalanthropology,sciencestudies,historyofscienceandthelike,spell‘theend’10(inRogerCooter’srecentuseoftheterm)ofthe‘socialhistory’ofmedicine?Inhiscontributiontothisissue,‘AfterDeath/After-’Life’:TheSocialHistoryofMedicineinPost-Postmodernity’,Cooterarguesthatrecenttrendsinthehistoryofmedicinereflectchangingmethodologiesandconceptualpreferencesandthattheseself-sameprocesseshaveculminatedinanidentitycrisis.Purportedlydevoidoftheintellectualchargethatstimulatedthedisciplineinthe1970s,socialhistoryofmedicineisnow‘politicallyandintellectuallysterile’.However,forothers,attentiontothescholarshipofanddialoguewithscholarsinotherdisciplineshasinvolvedengagingwithempiricalresultsandtheor-eticalframeworksthatmaywellreshapeandreinvigoratethefieldinthefuture.AsErnstpointsout,oneconsequencemaybethatsocialhistoryofmedicinewillagainconnecttotheconstituencythatitwasclosetoinitsyouthbuthasmovedawayfromoverthelast20years—themedicalprofession.Interestingly,Cooterappearstoarriveatabroadlysimilarconclusionfromadifferentstartingpoint.Recentreflectionsonthehistoryofthediscipline,includinganumberofcontributionstothisissue,suggestthatthelegacyofFoucaulthasmuchtoanswerforintermsof11currentanxietiesaboutdisciplinarityandtheoperationsofmedicalpowerandpolitics.Foucault’sclaimsaboutthewaysinwhichsomaticexperiencesandmedicalepistem-ologieshavebeenshapedbybiopoweranditsdiscursivepracticeshavesetmuchoftheagendafor‘theculturalturn’inthehistoryofmedicineanditsallieddisciplinesduringthelasttwodecades.Foucaultalsopavedthewayforcross-disciplinaryknow-ledgeandcritiqueof‘thebody’.However,accordingtoCooter,Foucaultprovided‘noformulaicpoliticalsolutions’totheproblemsheidentified.NowmaybethetimetomovebeyondFoucaultianstudieswhichprivilege‘governmentality’asappliedtonormsanddeviationsofmedicaldiscourseandattemptamorenuancedapproachtotheteasing-apartofthe‘entanglementsofbiomedicine’anditspost-postmodern12‘biospheres’—bio-power,politics,terrorism,identity,ontology,andsoon.Weare,inotherwords,facedwithnewlociofinvestigationdefinableintermsofwhatmightbelabelleda‘globalizingbiomentality’.Thereisnowanestablishedandrichcorpusofresearchanalysingthewaysinwhichsomaticexperience,medico-scientificknowledgeandthephilosophyof‘lifeitself’havebeenhistorically(re)constituted.Scholarshipfromhumanitiesaswellassocialscience-baseddisciplines—muchofwhichhasappearedinourpagesovertheprevious20years—hasprovidedthetoolstoinvestigatethecomplexcommercial,politicalandpublicarenasthatbiomedicinehascomeincreasinglytooccupy.Questionsabouttheorganisationofmedicalknowledgeandepistemologicalfoundationsof‘evidence-basedmedicine’,howbesttopractisemedicineinaglobalizingmarketplace,thelogisticsandethicsoftechnologytransferandthetransparencyandaccountabilityofresearchanddevelopmentinpublic/privatebiocapitalventures:allthesearenowquestionsforresearchersactingoutsideaswellasinsidetheworldsof‘bio-x’.AccordingtoCooter,rethinkingthepositionofsocialhistoryofmedicinecan10CooterinHuismanandWarner(eds)2004.11SindinginHuismanandWarner(eds)2004.12FoucaultinBurchelletal.(eds)1991. Editorial439yield‘newandmorepositiveways[inwhich]historiansmightevendeepentheirengage-mentwithpractitionersofcontemporarymedicine,appreciating(whilesavouringtheirony)that,likehistorians,theytoohavebeendestabilisedandnowsearchfornewwaystointellectualise’.Thetopicsbrieflymentionedhere,andmorefullydevelopedbycontributorstothisanniversaryissue,generateanumberofconclusions.First,thenumberofinternalcita-tionsandrepliestoourarticlesthatwepublishdemonstratethatSocialHistoryofMedi-cinehasdevelopedintoanevenmorelivelyforumforscholarlydebate.Second,thejournalremainsreceptivetodifferentmethodologicalapproaches,quantitativeaswellasqualitativehistory,syntheticaswellascase-studyapproachestodocumentaryanalysis.Third,thejournalhasbecomeincreasinglyinterdisciplinary—geographers,socialscien-tists,anthropologists,publichealthandmedicalresearchers,artandliteraryscholars,aswellaseverycategoryofhistorianscontributetoSocialHistoryofMedicine.Thisaddstothediversityoftheoreticalandmethodologicalapproachestotheinterpretationofhealth,disease,therapiesandnearlyeverythingelseinthebiomedicaluniverse.NotingthefactthatSocialHistoryofMedicinereceivesahigher‘impactfactor’thantheBulletinfortheHistoryofMedicineorMedicalHistory,arecentTimesLiterarySup-plementreviewerpraisedourauthorsforpursuingtheirsubject‘withomnivorous13verve’.Itissurelyanaccoladeforapeer-reviewedacademicjournalthatanevaluationofthiskindproclaimsthatourcopy—some600pagesayearpresentingroughly30originalarticlesand60bookreviews—isreadable:infact,‘enjoyableandapproachableenoughtonudgeitswayoutofalibraryandontoacoffeetable’.Sincethelast20yearshavenotseenmuchimprovementinlibrarybudgets,thisisareassuringevaluation.Itisalsoreassuringthatourmembershipandauthorsrepresenttheinternationalscholarlycommunity,withgrowthinNorthAmerica,AsiaandEurope.Weareineverywaymoving‘beyondthelocal’.Whateverthelevelofourfuturereadership,itistothemagnificentdiversityandtalentofourcontributorsthatweoweoursuccessoverthelasttwodecades.BrianDolanCo-editorBibliographyBurchD.2007,‘SocialHistoryofMedicine’,TimesLiterarySupplement,30March.BryderL.andSmithR.1988,‘EditorialIntroduction’,SocialHistoryofMedicine,1,v–vii.CondrauF.andWorboysM.2007,‘EpidemicsandInfectionsinNineteenth-CenturyBritain’,SocialHistoryofMedicine,20,147–58.CookH.2007,MattersofExchange:Commerce,ScienceandMedicineintheDutchGoldenAge,NewHaven:Yale.CooterR.2004,‘“Framing”theEndoftheSocialHistoryofMedicine’,inHuismanF.andWarnerJ.H.(eds),LocatingMedicalHistory:TheStoriesandTheirMeanings,BaltimoreandLondon:TheJohnsHopkinsPress,309–37.Earner-ByrneL.2006,‘ManagingMotherhood:NegotiatingaMaternityServiceforCatholicMothersinDublin,1930–1954’,SocialHistoryofMedicine,19,261–77.FeeE.andWeindlingP.1997,‘Editorial’,SocialHistoryofMedicine,10,1.13Burch2007. 440BrianDolanFoucaultM.1991,‘Governmentality’,trans.RosiBraidottiandrevisedbyColinGordon,inBurchellG.,GordonC.andMillerP.(eds),TheFoucaultEffect:StudiesinGovernmentality,Chicago:UniversityofChicagoPress,87–104.FoxE.1993,‘AnHonourableCallingoraDespisedOccupation:LicensedMidwiferyanditsRelation-shiptoDistrictNursinginEnglandandWalesbefore1948’,SocialHistoryofMedicine,6,237–59.HarleyD.1990,‘HistoriansasDemonologists:TheMythoftheMidwife-witch’,SocialHistoryofMedicine,3,1–26.HarrisB.2004,‘PublicHealth,Nutrition,andtheDeclineofMortality:TheMcKeownThesisRevisited’,SocialHistoryofMedicine,17,379–407.HomeiA.2006,‘BirthAttendantsinMeijiJapan:TheRiseofaMedicalBirthModelandtheNewDivisionofLabour’,SocialHistoryofMedicine,19,407–24.LangS.2005,‘DroptheDemonDai:MaternalMortalityandtheStateinColonialMadras,1840–1875’,SocialHistoryofMedicine,18,357–78.LoudonI.1988,‘MaternalMortality:1880–1950.SomeRegionalandInternationalComparisons’,SocialHistoryofMedicine,1,183–228.LoudonI.1991,‘OnMaternalandInfantMortality1900–1960’,SocialHistoryofMedicine,4,29–73.MarksS.1997,‘WhatisColonialaboutColonialMedicine?AndWhathasHappenedtoImperialismandHealth?’,SocialHistoryofMedicine,10,205–19.McintoshT.1998,‘Profession,Skill,orDomesticDuty?MidwiferyinSheffield,1881–1936’,SocialHistoryofMedicine,11,403–20.PickstoneJ.V.2005,‘MedicalHistoryasaWayofLife’,SocialHistoryofMedicine,18,307–23.PorterD.1995,‘TheMissionofSocialHistoryofMedicine:AnHistoricalOverview’,SocialHistoryofMedicine,8,345–59.SindingC.2004,‘ThePowerofNorms:GeorgesCanguilhem,MichelFoucaultandtheHistoryofMedicine’,inHuismanF.andWarnerJ.H.(eds),LocatingMedicalHistory:TheStoriesandTheirMeanings,BaltimoreandLondon:TheJohnsHopkinsPress,262–84.ThomasS.2003,‘MidwiferyandSocietyinRestorationYork’,SocialHistoryofMedicine,16,1–16.TuchmanA.M.2005,‘“TheTrueAssistanttotheObstetrician”:StateRegulationandtheLegalProtectionofMidwivesinNineteenth-CenturyPrussia’,SocialHistoryofMedicine,18,23–38.WoolcockH.R.,ThearleM.J.andSaundersK.1997,‘“MyBelovedChloroform”.AttitudestoChild-bearinginColonialQueensland:ACaseStudy’,SocialHistoryofMedicine,10,437–57.