This book is terrible. Don't read it. (Well, read it if you want to, but be aware it's terrible.)
Shorter argues that, while depression and other mentaThis book is terrible. Don't read it. (Well, read it if you want to, but be aware it's terrible.)
Shorter argues that, while depression and other mental health conditions have a somatic effect on the body, these effects are culturally specific and change over time. They are also class and gender specific, with women (Shorter concentrates almost entirely on women) in the middle and upper classes having different “acceptable” symptoms of “psychosomatic” illnesses than lower class women. He argued that these illnesses are real, but only become epidemics as the sufferers receive the positive attention from doctors and their families that they’re seeking. Shorter uses this to illustrate his argument that conditions such as fibromyalgia and Chronic Fatigue Syndrome are not physical illnesses, but brought about by depression.
He also argues that conditions such as anorexia (he does not discuss bulimia) are not weight-loss based but instead another symptom of mental illness, and blames both a desire for attention and a feeling of being smothered by the family (very specifically them other). He also makes very clear that he thinks the susceptibility to certain types of psychosomatic illness runs in families and thus is genetic/biological, rather than based on how one is raised. ["What the sufferers conceive to be genuine organic disease often comes from illness models self-consciously suggested to them by the class to which they belong." But at the same time he makes arguments such as the idea that working class people were also subject to hysteria, but middle-class people were more likely to seek help for physical sensations as illness. There is no discussion about who is able to afford medical care, and what medical care is recorded in official journals.] At one point he acknowledges that there are very few symptoms that are actually class specific (in discussing “bed cases” he agreed that they “seeped considerably down the social scale”), but then goes back to discussing the symptoms as class-specific, rather than the doctor’s reactions to those symptoms.
He argues that anorexia is caused by depression and a desire to punish one’s family, usually one’s mother. He also discusses how anorexia patients didn’t express a fear of becoming fat until “between the wars” - you know, that time when the ideal body type was the 1920s flapper.
Shorter primarily uses medical reports and medical journals to make his case, arguing that these are very rich. However, he makes an argument that young women in even the most rural of areas has access to information about how illness and disease was being treated in the late 19th and early 20th century, to take on the fashionable presentation of these illnesses (so, fainting and headaches, for example, as a form of hysteria) without demonstrating that the press ever discussed cases like this prior to women in rural Manitoba presenting symptoms.
He does at one point admit that women are more likely to be diagnosed as having psychosomatic illnesses in cases where the same symptoms in men are diagnosed as being organic in origin, but never follows this up or really seems to interrogate what that *means*.
Shorter unfortunately seems to rely a great deal on gender essentialism (women are like thus, men are like so). He uses “women” in a way that indicates that he mostly means white middle-class European women, with only little acknowledgment. (He occasionally discusses how some illnesses don’t seem to appear in non-Western societies.) (He also argues that women have a harder life than men, because women.) Race is little discussed, except in a chapter about Eastern European Jewish people (whom he characterizes as particularly prone to psychosomatic illness as a result of the trauma of the Holocaust - but then uses a variety of examples that pre-date it, and doesn't discuss any other racial group that might have a history of trauma, such as victims of the trans-Atlantic slave trade or the Irish Famine). While he acknowledges that some men experience psychosomatic symptoms, his book rarely discusses them, and certain does not dedicate an entire chapter.
He defines psychosomatic illness as "the perception of physical symptoms for which the patient seeks medical help and for which there is no organic cause."
Shorter argues that certain illnesses are more likely to strike people of certain age groups because they were fashionable in their youth. (Shorter’s explanation for older women becoming anorexic, for example, would be that anorexia was of particular concern when they were teenagers and imprinting on the idea of what anorexia was and its causes.)
He also argues that specific psychosomatic illnesses have changed their symptoms because of fears of “degeneration” brought about by the 19th’s attitudes towards eugenics.
While at one point he does he seem to entertain the notion that doctors just disliked certain types of patients and didn’t want to treat them, he again moves on from this without really interrogating how that would influence his theories about illness.
He occasionally acknowledges outright that doctors were pushing unnecessary surgeries as clients, many of which were fatal, but his disdain is primarily directed at the women who are suffering. The doctors get very little attention that isn't sympathy for dealing with these patients. The families are equally sympathetic.
So, Shorter's main argument is that "Ethnicity gives cultural meaning to one’s perception of one’s body." This is not something I disagree with, but I have been reading a great deal of medical history as of late. The case is made much more effectively in other works, ones that don't spend the entire book basically arguing "women, amirite?" ...more
"In the history of public health in the United States there is no date more important than 1866, no event more significant than the organization of th"In the history of public health in the United States there is no date more important than 1866, no event more significant than the organization of the Metropolitan Board of Health."
Summary: Rosenberg looks at the cholera outbreaks in New York City (with some details from other places) to examine how cholera was "defeated" through prevention rather than through development of a cure. The story focuses on the eventual rise of Health Boards and their successful work to clean the US's urban centers, specifically in New York.
Doctors are examined in terms of their changing theories with regards to treatment of cholera in addition to their struggles with the reputation of the discipline as being generally useless. It also looks at the growing materialism of US culture and the decline in importance of religious leaders.
Rosenberg also looks at class (or more specifically poverty) as poorer people were far more likely to die of cholera than richer people. Initially this was argued as evidence of divine punishment of the lower classes who were less likely to be religious and more likely to be blasphemous, alcoholics, or sex workers; however, later poverty was blamed for causing cholera because of the filthy living conditions of the poor. (Previously, rich people who died of cholera were thought or found out to have a secret vice that made them susceptible to the disease.)
This work also shows how within a very short period (34 years) the attitudes of both society and medical doctors can be changed through a paradigm shift (Rosenberg doesn't use that term, it comes from Thomas Kuhn's work on history of science, but it works well here). Between 1832 and 1866, there was a lot of work done on what caused Cholera (the maps of cholera sufferers from London - Dr. John Snow) and also on hygiene. As well, the NY Metropolitan Board of Health was given vast sweeping powers of change/control over the city. With the assistance of the NY Police Department, they managed to clean as much of the city as possible. With their success in keeping cholera figures low, they set the bar for how Boards of Health would work throughout the rest of the US. (Interesting to read in concert with other books that look at boards of health, specifically Nash.)
A key factor in all of this was the growing public health movement and its success with the Board of Health in NY.
By examining cholera epidemics, Rosenberg can track the changing reactions to a randomly recurring event to the US public (through newspapers), various political elites (through the responses of Boards of Health, mayors, and presidents), and medical practitioners (through medical journals and minutes). Note that this is an important part in the rise of municipal governments. As Boards of Health grew in power, it indicated how governments were given the powers necessary to deal with the problems that urbanization caused (or was perceived to cause).
Traces changing attitudes towards poverty & vice, causes of illness (bad behaviour/moralism versus product of environment)
Key terms: cholera, epidemic, public health movement, nineteenth century, medical history, materialism, urbanization, industrialization, paradigm shift, immigration
Petty Complaint: Rosenberg gets some details of Canadian geography wrong. (This is really irrelevant to the book though.)...more
"Ways of Knowing is an original and accessible guide to the history of science, technology and medicine, from the Renaissance to the present dayBlurb:
"Ways of Knowing is an original and accessible guide to the history of science, technology and medicine, from the Renaissance to the present day. The only study with this scope, it relates history to present concerns, and technical knowledge to everyday life. It brings out the major characteristics of science, technology and medicine in successful periods of history, while also revealing the many levels of understanding evident at any given period, including our own.
Ways of Knowing ranges from natural history to industrial science, from natural magic to the lures of modern commerce, and from the analysis of bodies, machines and languages to questions about the meanings of nature and science.
In fluent, non-technical prose this book makes available the best of recent scholarship on the history of science and on the usually separate histories of technology and medicine. Specialists in these fields will read it for the novelty of the approach; students of history and culture for the range and outreach. For all who are concerned with the ethical and political dimensions of science, Ways of Knowing provides long-term perspectives and tools for debate."
Pickstone asserts that there are many ways that science has been advanced since the renaissance - many ways of looking at the world and both understanding it and advancing our ways of controlling it. He call these “ways of knowing” and demonstrates how each of his “ways” - natural history, analysis, experimentation, technoscience, and world readings - are interrelated and continue without a break even today. This goes against the conventional history of scientific thinking that argues that older ways of knowing have been discarded and everything is bigger and better than before.
Pickstone shows how even our modern “technoscience” is adaption and incorporation of older concepts of the world. He takes a “big picture” approach to the work, tracing science, medicine and technology changing in the UK Germany, France, and the US. He owes some large debt to Kuhn’s earlier analysis.
According to Pickstone, this work “outlines the histories of science, technology, and medicine, not in a single chronological sequence, nor by discpline, but as different ways of knowing, each with its own history.” These ways are interconnected, found in any period, but they each varied in relative importance over time. The ways Pickstone highlights are “world reading” (hermeneutics - decoding of the world and systems of meaning found there), “natural history” (describing & classification of things), “analysis” (into various kinds of elements - cells or chemicals), “experimentalism” (control phenomena and systematically create novelties) and “technoscience” (projects which are dependent on science ore vice versa). (A modern example of natural history would be Wikipedia.) Much of STM can usefully be understood in terms of these ways of knowing and their interactions. Way of knowing are linked with ways of production, ways of making, tending, mending, defending or destroying.
This book has a long time scale and a breadth of scope. It dissects STM into constitutional elements (ways of knowing) with different history, and describes those ways as forms of work related to making and mending. Whereas histories of science have tended to highlight the scientific revolution (17th century), and technology has hinged or begun in the industrial revolution (1750 - 1850), and medicine in the birth of scientific medicine around 1870 or the birth of the clinic in 1800, this book pulls them all together.
It has admittedly been some time since I read it, so I can't give you a clear idea of how readable it is. It is more readable than Kuhn, but that's not really descriptive....more