In Sickness and in Health (original) (raw)

WE ARE AT A TIME in our history in which we face the dilemma of a technology which allows greater intervention in the body and the perception that our health dollar is diminishing. Several recent books on the social history of medicine have reminded us that medicine and health are social constructions, in which we define what is normal and what is abnormal. We also decide upon our society's responsibilities and allocate resources accordingly. All of these decisions are made within a particular culture, and as such reflect political and gender divisions in our society. Sickness and health are not only the product of germs we cannot see, but also ofthat other elusive agent -ideology. In The Nature of Their Bodies: Women and Their Doctors in Victorian Canada (Toronto, University of Toronto Press, 1991) Wendy Mitchinson shows how the perception of gender influenced the understanding of women's bodies, determined the understanding of their medical problems and prescribed the treatment. In essence, an almost exclusively male medical profession defined men as the norm and women as the "other". Differences between the bodies of men and women were seen as female deviations from the healthy male ideal. Even within this flawed paradigm, doctors were unable to perceive differences in sex objectively, but viewed them through the filter of Victorian gender and class ideologies. What emerges is a picture of physicians viewing women through gender preconceptions, and defining as "natural" the role that doctors perceived as the ideal for women. Any deviation from this they blamed upon "civilization". Thus when a larger portion of middle-class than working-class women sought medical care, doctors did not assume that this related to the ability to pay for consultations. They thought that middle-class women were having more difficulty with childbirth because they were further from nature. Men, who as the active agents in society were responsible for culture, would master nature and solve women's problems through medical science. Perceptions of men's and women's bodies reinforced the view of men as active and women as incapable of independent lives. The cult of science assumed greater authority in the late 19th century. But rather than liberating people from ideology, science created a false objective justification for the cultural premises upon which that science was based. Mitchinson bases her book upon the medical texts and journals that trained and informed physicians. In the hands of a less skilled historian this might have resulted in a teleological story of doctors' medical knowledge increasing and technique improving. But Mitchinson keeps her eye on the context within which knowledge of the body evolves. One is often left startled with the conceptions of medical problems, and the procedures inflicted on patients on the basis of these misunderstandings of how the human body works. The search for a biological basis for insanity, for example, encouraged the discovery of a link between "feminine" problems such as hysteria and pelvic disease. As is still the case in the 1990s with such conditions as pre-menstrual syndrome, women's frustrations were dismissed as a part of their nature and our society was thus not expected to address the difficulties placed in women's way. Despite its trenchant findings, this book is not an attack on the