Review of Sari Altschuler's "The Medical Imagination: Literature and Health in the Early United States" (original) (raw)
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In this new monograph, Thomas A. Apel provides a compelling examination of the intellectual controversy surrounding outbreaks of yellow fever in the northeastern United States at the turn of the nineteenth century. As well as an account of the " yellow fever controversy, " Apel unpacks the debate's broader cultural and intellectual underpinnings. At the center of the discourse on yellow fever, Apel demonstrates, were well-known physicians such as Benjamin Rush and Samuel L. Mitchill, who wrestled with broader streams in Enlightenment thought, including the influence of materialism, conspiratorial fears of political factions in the new American republic, the chemistry of Antoine-Laurent Lavoisier, and history's role in understanding the natural world. Through chapters organized around these themes, Apel teases out the deeper intellectual anxieties present in the debate over the origins of yellow fever. In chapter one, Apel establishes the terms of the debate: did yellow fever spring from local causes or was it imported? University-trained physicians such as Benjamin Rush and Samuel L. Mitchill led the localists, who ultimately won the debate, while surgeons such as William Currie and Isaac Cathrall acted as spokespeople for the contagionists. Rush and other localists, noting that yellow fever seemed to strike only swampy ports, reasoned that yellow fever was produced from the local environment. In contrast, contagionists concluded that since yellow fever outbreaks followed the arrival of diseased ships, the only observable solution was that it had been imported. In short, localists saw a common sense connection between places and epidemics , while contagionists championed their theory due to the coincidence of diseased ships and cases of yellow fever. In the next two chapters Apel enriches what is otherwise a familiar narrative, uncovering how contagionists and localists used history and chemistry to undergird their theories of yellow fever's origins. Contagionists created historical narratives of
Predisposing Causes and Public Health in Early Nineteenth-Century Medical Thought 1 Downloaded from
SUMMARY. The key aetiological issue of the early British public health movement is often seen to be the controversy between contagionism and anticontagionism. More fundamental, however, was a legacy from older constitutional conceptions of disease, of a distinction between exciting and predisposing causes. The centrality of predisposition was a theme in a wide range of medical writings; often predisposing causes were seen as sufficient causes for outbreaks of disease. Physicians who focused on predisposition often, though not always, took an interest in social factors that generated disease. The early public health movement associated with Edwin Chadwick represented then, not the victory of anticontagionism over contagionism, but the gratuitous rejection of a sophisticated understanding of the manifold determinants of health, in favour of a focus on a single, and hypothetical exciting cause. This article points out the inadequacies of the contagionism-anticontagionism characterization of early nineteenth-century aeti-ological theory, examines the concept of predispositionism as it appeared in the works of many writers, and considers in detail investigations of the Irish fever outbreak of1817— 19, where the concept of predisposition was extensively utilized, and the arguments with which the concept was rejected by Chadwick's associates Thomas Southwood Smith and Neil Arnott. In a classic essay on the 'Therapeutic Revolution' Charles Rosenberg took on the task of laying out the framework within which 'traditional' therapeutics 'worked'; what made the purges, emetics, bleedings, and tonics seem the rational, obvious, and necessary interventions to doctors in early nineteenth-century America and to their patients as well? 2 These remedies worked, Rosenberg pointed out, within a framework of pathologies of imbalance— pathologies that were still humoral, however far they might have evolved from classical humoral tradition. It was a framework that integrated body and mind, pictured health as the maintenance of a delicate equilibrium in the face of all manner of disturbing influences on the constitution. Perhaps most importantly, it was a framework in which the ill person shared the responsibility for defining his or her condition. In this paper I focus on that framework as it existed in Britain in the same period, and on another component: its conventions with regard to explaining the causes of disease. By exploring how aetiological questions were handled both in general medical textbooks and in works on particular diseases or particular epidemics, we can, I hope, recognize more
Amerikastudien/American Studies
In a 2016 article in The Guardian, Phil Whitaker explains why a substantial number of well-known writers are also medical doctors. Whitaker, who belongs in this group himself, lists Anton Chekhov, Michael Crichton, Khaled Hosseini, and a few others, to state his point: "Their ability to feel what others feel, and simultaneously to view it with detachment, gives us perhaps our greatest strength as writers." Importantly, it is the physician's skills that pave the way towards writing as a profession, and not literary excellence that helps make a professional healer: doctors virtually read "[e]ach patient's illness" as "a narrative-symptoms as the beginning, diagnosis as the ending-and a middle that weaves a coherent and irresistible path between the two." Such explanations sound logical and comprehensible, yet they evoke new questions as well: why does it seem to be, almost exclusively, men, who translate their interaction with patients into poetry and prose? What motivates them to do so? Does their creative engagement inform their work as medical doctors? And, most importantly, perhaps: what do we learn about the medical profession, about writing, about an era, when we replace the hierarchical concept of the doctor-becoming-awriter by the idea of a mutually inspiring relationship between two systems of knowledge acquisition? Sari Altschuler's The Medical Imagination: Literature and Health in the Early United States builds on this idea of reciprocity. The book approaches "the practice of writing" as a "valuable training of the medical mind" (5) and discusses a number of well-known American physician-writers who wrote poetry or prose between the American Revolution and the Civil War. As public intellectuals, they relied on what Altschuler calls "imaginative experimentation" (8-11) to study and discuss health-related topics, test medical theories, fill research gaps, and solve medical and philosophical contradictions. Unlike Joan Burbick's Healing the Republic (1994) and other path-breaking publications in the field of medical humanities, The Medical Imagination does not reference physicians' writings to make a general statement about national health or American culture: carefully researched and very readable, the book sketches out an intellectually agile and dynamic community of early American physician-writers. It sheds light on individual biographies and friendships, emphasizes generational and cross-generational connections and conversations, and carves out the political concerns of individual participants who steered the relationship between health and literature in new directions. These medical men believed in the power of narrative to either cure or cause harm, but instead of resorting to narratives of healing, they preferred to outline and discuss the relationship between art and science, "imaginative experimentation," and "reductive, mechanistic paradigms" (102). Building on a variety of contexts, and rich in detail, The Medical Imagination offers an in-depth analysis of the life and oeuvre of key figures in American medical and literary history, including Benjamin Rush,
CONTAGIOUS DISEASES AND ITS REFLECTION IN LITERATURE
Review of Research, 2022
The purpose of this study is to provide light on the reflection of epidemics and pandemics on the literature, individuals and families; politics and foreign affairs; the medical profession, public health, community health groups, and health education programmes local, state, and federal governments, as well as commercial enterprise; and, last but not least, the national mood with remedies, research, antidotes & type of care which will be portrayed by many writers in their works. In the past, authors such as Homer and Shakespeare, as well as Albert Camus, Jack Londen, Daniel Defoe, Thomas Mann, and Garbiel Garcia Maquez, have created notable works about epidemics and pandemic that have lasted the test of time.