Showing 1 - 10 of 504 annotations tagged with the keyword "History of Medicine"

Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Victorians Undone is no ordinary history book.  If you have ever felt dissatisfied by a sterile biography, wondering if its subject actually possessed bodily functions, look no further.  Here, British historian Kathryn Hughes undoes centuries of sheltering the reader from the unseemly by putting it on full display.  While the very term “Victorian” evokes an image of propriety, it was also a time of population displacement from the country to cities where “other people’s sneezes, bums, elbows, smells, snores, farts and breathy whistles were, quite literally, in your face”  (p. xi). The author seeks to rectify the imbalance by creating a history that puts “mouths, bellies and beards back into the nineteenth century“ (p. xiv), which she hopes will “add something to our understanding of what it meant to be a human animal“ (p. xv) during the Victorian Era.  

The book consists of five essays, each following a part of the body of an historical figure. In the first, entitled “Lady Flora’s Belly,” we learn about the tragic saga of Queen Victoria’s lady-in-waiting.  Did Flora’s protuberant abdomen conceal a tumor or a baby?  It was harder to find out than one might think.  Most women went through their lives without ever exposing their private parts to anyone but their husband.   Medical consultation when unavoidable might be conducted discretely, by post. 
 

Other essays focus on George Eliot’s hands, Fanny Cornforth’s (the lover of Dante Gabriel Rossetti, the Pre-Raphaelite painter) sensual mouth, and the beard that Charles Darwin’s grew to hide his eczema.  The book concludes with the gruesome tale of the dismemberment of Fanny Adams, an early case study in forensic pathology. The term "Fanny Adams" soon came, in navy slang, to mean unpleasant meat rations.

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Annotated by:
Galbo, Sebastian

Primary Category: Literature / Nonfiction

Genre: History

Summary:

From the late 18th to mid-19th centuries a peculiar trend swept through European fashion. Through couture and cosmetics, this vogue emulated the physical ravages of a much-feared disease, tuberculosis, aestheticizing its symptoms as enviable qualities of physical beauty. Pale skin, stooped posture, white teeth, an emaciated figure, and a white complexion that evinced delicate blue veins were lauded by the era’s posh fashion journals. Carolyn A. Day aptly terms this craze a “tubercular moment,” a cultural phenomenon that elevated the grim realities of physical illness to a plane of desirable beauty. Medical discourses promoting the fragility and refinement of the “sensible” body were inspired by romanticized notions of morbidity, suffering, and illness. These discourses coincided with the the ideologies of Romanticism, a philosophical movement that was popularly understood to be a counter-discourse to the Enlightenment through its emphasis on emotion and imagination. Day cites the English poet, John Keats, whose legacy emphatically contributed to the cult of sensibility, as he embodied a living example of the refined tubercular body endowed with artistic genius but doomed to illness. The male artist was an example of a body too sensitive, too delicate to endure earthly life, but one whose intellect left an indelible imprint on culture.  

The romanticized construction of tuberculosis, however, waned in the 1830s and 1840s due to dominant Victorian views that emphasized the inherent biological weakness of the female body. This shift in rationalizing consumption was the direct result of understanding women as burdened with a surfeit of sensibility. By contrast, consumption was understood differently to be an emasculating illness that denoted male weakness and was therefore no longer popularly considered to be a portent of gifted creativity. During this period, a number of women’s fashions dictated the tastes of the middle and upper classes. Corsets, cosmetics, and the gossamer neoclassical style of dress were used to emulate the frail frames, drooping postures, narrow torsos, and pale complexions of the consumptive body. Thin fabrics, sandals, and hair pieces also contributed to styling the ‘gorgeously’ spectral image of the tubercular body. Dresses were contrived to feature the bony wing-like shoulder blades of the consumptive back, emphasizing an emaciated frame. Physicians and cultural pundits condemned the trappings of this fashionable dress because they were thought to impose health risks. Tight corsets, for example, were considered to harmfully compress the lungs, while diaphanous dresses and sandals exposed women to cold weather. Despite the stentorian warnings of physicians, the tubercular wardrobe continued to house articles that were thought to excite tuberculosis.  


By the 1850s, public health and sanitary reforms reshaped cultural discourses that associated tuberculosis with beauty. Tuberculosis was gradually viewed as a pernicious biological force that needed to be controlled. As a result, the Victorian model of womanhood—the weak and susceptible female body—gave way to a model of health and strength. Literature, as Day points out, contributed significantly to altering the consumptive chic discourse and the link between tuberculosis and ideal femininity. She references Alexandre Dumas fils, whose influential novel, La Dame aux Camélias, presents redemption for moral transgressions through tubercular suffering. Through popular literature, tuberculosis was gradually supplanted from the sphere of upper-class women and placed in association with ‘fallen’ women, an unsavory association that led the genteel public to change perspective. Literary influence was important, but the increased visibility of consumption in the lower classes was likely the most visceral reality that forced upper classes to distance themselves from fashions that beautified the illness.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1869 in the remote northern Scottish village of Culduie, teenager Roderick (Roddy) Macrae brutally murders his neighbor, Lachlan “Broad’ Mackenzie, and two others. He readily admits to his crime, motivated, he says, by a desire to end the dreadful vendetta that Broad waged against his widowed father. The sympathetic defence lawyer, Andrew Simpson, urges him to write an account of the events leading up to the tragedy.  

Roddy agrees. In a surprisingly articulate essay, the young crofter describes his motive, originating with his birth and escalating through the lad’s mercy killing of an injured sheep belonging to Broad (interpreted as wanton), Broad’s sexual torment of his sister and mother, and his abuse of power as a constable that strips the family of land, crops, and finally their home.  

Given Roddy’s passivity, intelligence, and previously clean record, Simpson prepares a defence of temporary insanity and brings two physicians to assess his client, one a purported expert in the new field of medical criminology.  
 

The jury trial proceeds with an almost verbatim transcript derived from newspaper sources. The reader is able to juxtapose Roderick’s account with that presented in court. To report the outcome here would reveal too much.

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The River of Consciousness

Sacks, Oliver

Last Updated: Mar-01-2018

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Two weeks before his death in 2015, Sacks oversaw this collection of essays and charged Kate Edgar, Daniel Frank, and Bill Hayes to arrange its publication. The essays touch on various fields—evolution, botany, chemistry, medicine, neuroscience, and the arts, and focus on major figures such as Darwin, Freud, and William James. The major theme—as indicated by the volume’s title—is how minds (of humans, chimps, even jellyfish) interpret and remember what the senses perceive in normal and in limited states. While we read in the Foreword that “a number” of the pieces originally appeared in The New York Review of Books, there are no citations for dates and places.  

“Darwin and the Meaning of Flowers”: Sacks describes Darwin’s research with flowers that support evolution; flowing plants display qualities of sensitivity to “contact, pressure moisture, chemical gradients, etc” (p. 19). Sacks recalls the pleasures of investigating flowers as a youth in his London garden.  

“Speed” : Drawing on personal experience and a wide variety of anecdotes (including his encephalitic patients described in Awakenings), Sacks muses about mental perceptions, slow and fast, normal and drug-enhanced, dreams, and our ability to imagine “all speeds, all time” (p. 59).  

“Sentience: The Mental Lives of Plants and Worms”: Starting with Darwin and coming forward, Sacks discuss how worms, jellyfish, and even trees may be considered to exhibit “mind.” Near the end, we read, “if one allows that a dog may have consciousness of a significant and individual sort, one has to allow it for an octopus too” (p. 76).  
   
“The Other Road: Freud as Neurologist”: The opening paragraph ably sums up the essay. “Everyone knows Freud as the father of psychoanalysis, but relatively few know about the twenty years (from 1876 to 1896) when he was primarily a neurologist and anatomist; Freud himself rarely referred to them in later life. Yet his neurological life was the precursor to his psychoanalytic one, and perhaps an essential key to it (p. 79).   
   
The next three may be considered as a group because they deal with lapses or outright failures in perception, memory, or health. Because Sacks reports on his own life experience, these are the most personal.
“The Fallibility of Memory” describes Sacks’s memories of the bombing of London in the winter of 1940-41. It turns out that one memory, according to family members, is right, but the other is actually a version of a letter describing a bombing.

The essay continues to discuss such topics as false memories, auto-plagiarism, unconscious plagiarism, and fabulation. He concludes, “Our only truth is narrative truth, the stories we tell each other and ourselves—the stories we continually recategorize and refine” (p. 121). In a short piece, “Mishearings,” Sacks reports how his increasing deafness makes new (and sometimes hilarious) perceptions of spoken words.  

Surely the last written—and in many ways the most poignant—“A General Feeling of Disorder” discusses feelings of being ill. Sacks, at age 81, describes his metastatic liver cancer and, in detail, an arduous treatment. Although warned of weakness and pain, he writes of “a sort of negative orgasm of pain” and other disturbing side effects (pp. 155-59) in vivid detail.  

“The Creative Self” discusses forms of creativity including play, scholarship, unconscious borrowing, and subconscious insight. Sacks is less interested in a Freudian model than an evocation of “an entire hidden, creative self” (p. 144).            

The final two, “The River of Consciousness” and “Scotoma: Forgetting and Neglect in Science” deal with theories of how the mind works and, more collectively, how scientific breakthroughs occur. The former essay explores cinematic models for perception in James and Bergson and much later models of the 100 billion neurons of the brain working on networks, coalitions, or populations. He finds that a specific mechanism is unlikely to be found and, “Even the highest powers of art—whether in film or theater, or literary narrative—can only convey the faintest intimation of what human consciousness is really like” (p. 174).

In “Scotoma” (or “memory hole”), he looks at discoveries that were over-looked for many years . Later they were rediscovered as important for understanding various phenomena: Tourette’s syndrome, phantom limbs, and, his specialty, migraines.

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I Have a Rendezvous with Death

Seeger, Alan

Last Updated: Feb-12-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Poetry — Secondary Category: Literature /

Genre: Poetry

Summary:

A short war poem of 24 lines in three verses, in the voice of a soldier who expects to die, “at some disputed barricade” in the spring, when “apple blossoms fill the air.”

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In Flanders Fields

McCrae, John

Last Updated: Feb-06-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

A short war poem of 15 lines in three verses, in the voice of dead soldiers who lie under the poppies that grow in the fields of Flanders.

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Summary:

Hillel D. Braude, a physician and a philosopher, has written an important, albeit dense and narrowly circumscribed, study. While “Intuition in Medicine” is the main title, the subtitle, “A Philosophical Defense of Clinical Reasoning” is a more accurate description of the book, which originated as a doctoral dissertation.  While some of the prose will appeal only to specialists, there are important and thoughtful analyses of such topics as Evidence-Based Medicine, modern dehumanized medicine, the relation of beneficence and automony, and principalist ethics in general. Throughout, intuition is narrowly conceived and in the service of clinical reasoning, as it applies to standard, Western physicians and not to other healers (or nurses), and the emphasis is on interventive medicine to cure illness and relieve suffering more than on health promotion.
 
Braude writes in the introduction that intuition has long been understood to be “a direct perception of things,” but he resists a more precise definition: “Rather than defining and using a single concept of intuition—philosophical, practical, or neuroscientific—this study examines intuition as it occurs at different levels and in different contexts of clinical reasoning” (xviii).  Eight chapters explore these different levels in such topics as moral intuitionism, Aristotle’s phronesis (or practical reason), the rise of statistics (a basis for Evidence-Based Medicine), and C. S. Peirce’s notion of abduction. Braude’s careful analysis traces historical and theoretical developments in analytic philosophy and how these may be applied to clinical reasoning.  He uses an impressive range of thinkers: Achenwall, Albert, Allan, Andre, Ashcroft, Aristotle, Bacon, Barrow, Barton, Beauchamp, Bergson, Bernard, Bichat, Black, Bottero, Bourdieu, Brody, Browne—just to take names headed by A or B.  Throughout, Braude puts in dialectic two poles of a spectrum arguing that they both have contributions to make. He believes that between them is an “ethical space,” where discoveries and applications can be made.  One pole, which he clearly favors, includes the following qualities:  Aristotelian practical reasoning, naturalist approaches, primacy of beneficence, fact and value joined, case-based, individual patients, narrative experience, anthropocentric focus, and tacit/organic knowledge (Polanyi). The other pole, less desirable, includes Kantian abstraction, nonnaturalist approaches, primacy of autonomy, fact and value separated, Evidence-Based Medicine, large groups of patients, statistical correlations, mechanist/positivist foci, and Dualism (Descartes).

Braude believes intuition is a cognitive process but has other dimension, the corporeal and the social. While these provide a grounding, intuition for him is generally rational. He also argues for medical care at the personal, face-to-face level, not through applications of algorithms.   A brief conclusion, “Medical Ethics beyond Ontology” clarifies some of the arguments and sketches some valuable notions from Husserl and Levinas. He writes “intuition . . . does appear to be fundamental for human judgment” because “an intuition faculty” can “extract universals from the particular” (p. 170).  Drawing on Husserl, he defines phenomenological intuition as “the primary means through which objects are presented to consciousness.” This affirmation includes the basic human, which is also the focus for medicine. For Levinas (and my summary is much too brief), “interhuman solidarity” is a source for medical care, a form of responsibility that is different from Foucaultian power relationships, ethical rules and priniciples, or “an uncritical acceptance of medical authority” (p. 177).

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Leonardo da Vinci

Isaacson, Walter

Last Updated: Jan-09-2018
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Leonardo da Vinci – the name alone evokes images of an artistic virtuoso, the Renaissance man, the mind behind the Mona Lisa. Though known best as an artist, his work extended beyond paintings into a myriad of disciplines, with notebook entries documenting his studies of optics, bird flight, comparative anatomy, hydraulics, and countless others. And yet what has been obscured by the shadow cast by his prolific career are the details of how a young man from a town called Vinci became Leonardo da Vinci. What did he do every day? What did he eat? Who were his friends? Did he even have any? We tend to immortalize Leonardo as a god, and yet he was human after all, not unlike the rest of us. This realization should encourage us to study one of history’s most celebrated humans, and see if we ourselves might be able unlock our own inner genius.

Walter Isaacson aids us in this study with his thoroughly researched biography of Leonardo da Vinci. He adds this to his growing portfolio of biographies of history’s great minds, including Benjamin Franklin, Albert Einstein, and Steve Jobs. In this most recent biography, Isaacson takes us through the life and times of Leonardo, highlighting milestones of his career, while also underscoring some of the seemingly trivial habits that were signatures of Leonardo’s personality and worldview.

Born of illegitimacy and openly gay, Leonardo was no stranger to defying convention. In fact, many of his grandest discoveries were a result of his willingness to challenge commonly accepted wisdom. Yet his greatest asset was his relentless curiosity and unquenchable thirst for knowledge, a recurring theme of Isaacson’s biography and of Leonardo’s life. Intertwined with this curiosity was his tendency to draw connections across disciplines, blurring the lines between art and science. Everything that Leonardo produced – whether his sketches of war machines, his treatises on anatomy, or his timeless portraits – was a manifestation of his desire for unifying knowledge.

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Sutton's Law

Wright, Linda; Orient, Jane

Last Updated: Jan-05-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Intern, Maggie Altman, begins her postgraduate training in a large Texas hospital where a new computerized system has been implemented to improve service. She pours heart and soul into her work, but her admissions always seem to be the sickest patients who keep dying, sometimes inexplicably. Maggie becomes suspicious of her colleagues and of Dr. Milton Silber, an irrascible, retired clinician with no fondness for the new technology. Silber also happens to be a financial genius. Overhearing conversations and finding puzzling papers, Maggie imagines a scam, in which her supervisors may be eliminating dying patients to reduce costs, improve statistics, and siphon funds to their own pockets.

The bad outcomes for Maggie's patients are noticed and criticized, and she is pressured to drop out, switch hospitals, or go back into research. She senses that the perpetrators are aware of her suspicions and send her the worst patients in an effort to eliminate her. She trusts no one. These worries are compounded by her own illness and her accidental discovery in the morgue of a traffic in unclaimed bodies. With the help of excellent clinical skills, true friends, Dr. Silber, and a new love interest who is a budding financial genius, she survives physical and emotional violence and solves the mystery of patient homicides, poisonings, and fraud.

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The Anatomist's Apprentice

Harris, Tessa

Last Updated: Jan-05-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1780, Thomas Silkstone, a young American surgeon and anatomist, is invited by Lydia to establish the cause of death of her brother, Lord Crick, a dissolute who held the Oxfordshire estate that she will inherit. Her goal is to absolve her husband of the suspicion of murder; however, as the investigation proceeds, it increasingly seems that her husband is guilty after all.

 The earnest young doctor methodically examines each new lead—performing experiments on tissues and with various poisons in his effort to determine the cause of death – and in so doing solve a murder. Before long, another person is dead and Thomas is in love with Lydia, a scarcely concealed complication that calls his testimony into question.

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