Summary:

This book combines social history with personal memoir. It serves as a reflection on how the various challenges of living with chronic illness have shifted over time, and how they are still real and present for the increasing portion of the population who suffer from ills invisible to others and often hard to account for.  The book's brief treatments of cultural and medical approaches to chronic illness, from ancient practices to "patients in the digital age," provide a broad perspective against which to consider current legislative, political, medical, and personal concerns for those coping with chronic illness or disability. 

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Parts of medical history read like detective novels.  The discovery of the source of cholera by Dr. John Snow in London in 1854 is one of those episodes.  The Ghost Map tells the story of Snow's pioneering work in what have now become standard epidemiological methods.  Tracing a cholera outbreak to a local pump in a poor section of London involved many door-to-door visits working with people who weren't always cooperative, incurring the suspicion and/or ridicule of both them and the medical professionals with whom he worked.  In the course of the story the author offers reflections on the organization of cities and on public hygiene.  Snow, an out-of-the-box thinker, also helped develop surgical anesthesia. 

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The two parts of this work investigate judicial punishments in imperial China as well as 18^th and 19^th century  Western reactions to and obsession with  Chinese methods of torture and with the Chinese method of public execution called death by a thousand cuts (lingchi). The authors present their interdisciplinary study as a "cross-cultural hermeneutics" (245), concluding that this use of torture and tormented death in China is not special but forms part of a global pattern of state-sponsored cruel and inhumane punishments recorded over time.

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The Crimean War (1853-1856) holds a place in the history of medicine, specifically, the history of nursing. For as the British public read the 1850s Times reports about the total lack of care suffered by their wounded in this conflict, a British nurse, Florence Nightingale, volunteered to recruit a team of nurses to aid the suffering men. The Times created a relief fund for the sick and wounded, and Queen Victoria, an enthusiastic supporter of this war against Russia, sponsored an even larger fund. Female nurses had a reputation for drunkenness and promiscuity. Nightingale made it a point to recruit nuns and women from the lower classes who would be more manageable than educated, upper class women. Three black nurses applied, including Mary Seacole, but they were rejected.

The Turks, British allies, allowed Florence Nightingale the use of their army barracks at Scutari, across from Constantinople: "'I have been well acquainted with the dwellings of the worst parts of most of the great cities of Europe,' Nightingale wrote,' but have never been in any atmosphere which I could compare with that of the Barrack Hospital at night'" (111). Open sewers ran beneath these vermin-infested structures  which were crammed with sick soldiers lying on the filthy floor. There were no supplies and few doctors. Typhus, typhoid, cholera or dysentery killed many patients. Nightingale's meticulous statistics showed alarming escalation of mortality rates; she believed in cleanliness and fresh air but not in the germ theory of disease. When comparing her numbers with those of other military hospitals, Nightingale understood that soap alone would not save the men.

Rappaport describes the nursing offered by army wives, widows and other volunteers, including French nuns. The women's living conditions, especially during pregnancy and childbirth, often resulted in sickness and death. Others volunteered as cooks, including Elizabeth Davis who alleged that while "...she and the other nurses dined on the stewed-up, tough old meat used to make soup for the patients, Nightingale ‘had a French cook, and three courses of the best of every kind of food ... served up everyday at her table'" (168-169).

Nightingale became famous as the heroine of the Crimean War. She is known now as the founder of professional nursing. Recent research has questioned whether Nightingale was the real angel of the Crimea. Rappaport investigates the work of the Jamaican nurse, healer, and entrepreneur Mary Seacole, one of the 3 black nurses rejected for service in the Crimean War. She financed her journey to and stay in the Crimea herself. She built a British Hospital in the Crimea, and treated the wounded at Balaklava there and in the field. The soldiers called her Mother Seacole because she cared for their material and spiritual needs. She sold gin and raki and home-cooked meals, and went bankrupt because too generous with credit. Seacole recouped her losses and achieved bestseller status with her memoir, Mrs. Seacole's Wonderful Adventures in Many Lands (1857), the first memoir by a black woman from Britain.

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This is the wrenching history of the development, evolution, and eventual obsolescence of the leper colony established in 1866 on the isolated and only sometimes accessible peninsula on the Hawaiian island of Molokai--and the lives of the people who were exiled there to die over a period of more than 100 years. The tale opens with the declaration by the Board of Health that all persons proven (or strongly suggested) to be afflicted with leprosy be exiled immediately to the site on Molokai.

The author dramatically describes the selection and separation of the exiles from their families and the tortuous and sometimes deadly sea voyage to their primitive new homeland. Mixed with the public policy and the individuals who made and implemented it, are the descriptions of the hospital in Honolulu where diagnoses and dispositions were rendered, as well as the poignant personal stories of the "detainees." The reader follows the colony from the arrival of its first 13 patients in 1866, through its peak population of 1,144, to its residual 28 in 2003.

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This volume belongs in the category of cross-cultural studies of medicine and the humanities. Its main audience is scholars of nineteenth-century American psychiatry and culture. The author divides his study into six chapters, each with a topic, including the simultaneous emergence of nineteenth-century public debate about improving the treatment of insanity and the movement to abolish slavery; cultural activities in asylums directed toward humanizing the patients; bardolatry in British and American medical circles; discussions of Emerson, Hawthorne, Poe, and Melville in the context of their literary and personal relationship with madness; a chapter on captivity narratives and popular novels by former female and male patients; and an epilogue.

Unlike today, "In mid-nineteenth-century America, the condition of the mentally ill seemed to demand-and to a large degree received-national attention and the full creative energy of a group of dedicated reformers" (p. 2). Reformers linked the emancipation of slaves with curing the delusions of the insane. Slaves and the mentally ill had in common deprivation of their civil liberties; however, the difference was that white mental patients could be expected to grow up eventually, whereas black slaves would always remain children, and hence could not be trusted with the right to vote, own property, or sign contracts.Some causes of insanity were deemed to be the individual's reaction to the stress of modern life, too much freedom and choice, religious fervor, masturbation, or excessive study. In their aggressive attempts to remake patients into proper gentlemen and ladies, the new asylums promoted cultural activities such as reading selected texts, theater performances and writing.

Most asylums housed males and females in approximately equal numbers; cultural activities for females stressed piety, fashion, and domestic activity while men could comment on politics, the temperance movement, and opposition to women's rights. Reiss refers to the French model of using cultural activities in asylums, f.ex., Philippe Pinel's staging of plays to educate patients, and Marquis de Sade's theater performances at Charenton. He ends with a discussion of patient narratives that depict some horrific abuses tolerated in nineteenth-century asylums; the degree of these abuses is familiar to us from One Flew Over the Cuckoo's Nest (see film annotation).

The work includes a few illustrations, the most important being an engraving from a painting by Tony Robert-Fleury titled: Pinel Freeing the Insane (1876). (Yale University). Philippe Pinel (1745-1826) was a French pioneer in the humane treatment of mentally ill patients. A Director of Bicêtre Hospital in Paris, he is depicted as a heroic physician, liberating, mostly female, patients there. However, scholars have shown that only 10 of the 270 patients were chained, and that Pinel '"accepted the traditional use of chains to restrain the violent insane as a matter of course"' (p. 160). Reiss's point is that the revolutionary nature of Pinel's treatment of the insane has been exaggerated.

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Written by a psychiatrist and historian, American Melancholy: Constructions of Depression in the Twentieth Century looks at how culture, politics and, in particular, gender have played a role in the development of a diagnosis.  Hirshbein moves between several different worlds, showing how they intercalate and, indeed, are very much part of the same world: psychiatric nosology and cultural attitudes to the gendered expression of emotion and feelings, medication trials and magazine advice to women about how they should deal with the blues, the relations between treatment paradigms and how society views suffering.

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A memoir of raising a daughter with autism and an anthropological and historical investigation into autism around the world, Unstrange Minds: Remapping the World of Autism draws upon Grinker's own experiences, those of families of children with autism in the United States, Korea, India and South Africa, and a variety of experts and caregivers.  Putting the story of autism into a historical, anthropological, and personal context, the book deals with hot-button topics - the question of an autism epidemic, of etiology, of treatments - with a careful, patient approach.

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Medicine and religion cross paths in the examination of miracles and the canonization process of Roman Catholic saints. The author of this book, a medical historian and hematologist, compiles an impressive amount of data procured largely from four trips to the Vatican Secret Archives. She reviews 1,400 miracles from the time period 1588 to 1999 and discovers that 95% of these phenomena involve the healing of a physical illness. The author scrutinizes the nature of these miracles and investigates the dynamics and beneficiaries of them.

Medical expertise plays a central role in the substantiation of miracles. After all, miracles that involve healing imply a failure of medical treatment. Over the centuries, any physician providing testimony about the occurrence of a possible miracle must address two issues. The doctor must confirm the hopelessness of a patient's prognosis. The doctor must admit that the positive outcome of the case is nothing short of astonishing. The text is adorned by some splendid and strange paintings that illustrate people requesting or receiving miracles. It profiles celebrities in the history of the canonization process such as Prospero Lambertini (Pope Benedict XIV) and Paolo Zacchia.

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This study sets forth the mystery of scurvy  which devastated the British Navy during the eighteenth century. Among several diseases common on board, including yellow fever, typhus, or typhoid fever, syphilis, tuberculosis, and dysentery, scurvy was the most devastating. Caused by a lack of vitamin C, scurvy’s symptoms appear as swollen and bleeding gums, livid spots on the skin, and prostration. Untreated, the illness results in agonizing death. When Commodore George Anson’s flagship, Centurion, sailed from Plymouth in 1741, rounded Cap Horn and returned to Britain, his ship carried home only two hundred of the two thousand men he set out with. A deadly combination of voyages lasting a year or more, unhealthy conditions on board, including malnutrition, filth, crowding, ignorance about basic facts of biology, as well as inexperienced sailors pressed into crewing on ships managed by violent officers using harsh physical punishment resulted in millions of deaths at sea from the age of Columbus to the nineteenth century, when scurvy remedies were finally found.

Bown credits three men with discovering a solution to the mystery of scurvy: a surgeon, James Lind (1716-1794), sea captain James Cook (1728-1779), and a  physician, Gilbert Blane (1749-1843). Lemon juice had been known to prevent and cure scurvy since the 17^th century, but 18^th century medical men disregarded empirical knowledge in favor of the theory of humours.

James Lind entered the Royal Navy as a surgeon’s mate in 1739 under appalling conditions similar to those described by Tobias Smollett in Roderick Random (1748). He initiated a two-week controlled experiment where he separated the afflicted sailors into 6 groups who each received a different diet: cider, vitriol, vinegar, sea water, oranges and lemons, and nutmeg paste. The group receiving the oranges and lemons obtained the best results. Lind published his treatise on scurvy in 1753. However, he was unable to explain the causes of scurvy and why oranges and lemons led to its cure.

James Cook circumnavigated the world 3 times. On his lengthy voyages, he stopped for fresh fruits and antiscorbutics wherever he could, as he noticed these kept the seamen free of scurvy. Cook showed that scurvy was curable, but not why.

During the War of American Independence, Gilbert Blane served as a physician on board several warships in the British Navy. He instituted a diet of fresh fruits and better hygiene on board ship. He published Observations on the Diseases Incident to Seamen, in which he advocated using oranges and lemons to cure scurvy. He advised that lemon juice be mixed into the sailors’ grog.

The British Navy encountered an historic ordeal in 1805 with the Battle of Trafalgar. Admiral Nelson, commander of the British Navy, had nearly died from scurvy in 1780. Now he faced Napoleon Bonaparte and the French fleet. Bown argues that the near- elimination of scurvy on board their ships contributed mightily to the British victory.

A timeline, from 1492 to 1933, concludes the volume. Recommended readings, a bibliography and an index are provided.

 

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