[lit-ideas] Re: remebering 1906
- From: David Ritchie <ritchierd@xxxxxxxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Tue, 16 Jan 2007 21:54:38 -0800
Robert Paul is right.
It's been more than twenty years since I taught a history of medicine
course in a medical school, so I checked my rather dusty history of
medicine shelf for books that had good numbers on who died of what in
1906 or before. Though my collection is out of date, it's clear that
historians of medicine were writing around this particular problem of
data. Take, for example, L.J.Rather, "The Genesis of Cancer," which
one might think would explain whether there is more cancer in the
twentieth century than the nineteenth. The book is subtitled, "A Study
in the History of Ideas," and is not about how many people suffered
cancer but what people thought cancer was. Other studies write about
social hierarchies among doctors, how hospitals were organized,
clinical research...the sorts of thing that record reveal. What
records don't reveal very well is who died of what.
My own Ph.D. thesis has things to say on the different ways in which
shell-shock statistics were counted, reported, recorded.
I'll report three things that can be said on this subject of late
nineteenth and early twentieth century mortality. John Woodward, "To
Do the Sick No Harm," established that the view of nineteenth century
hospitals as "gateways to death" was erroneous. His tables show that
excluding periods of epidemic contagioun, in the second half of the
nineteenth century British hospitals had mortality rates between three
and twelve percent of admissions. Secondly, it's true that infant
mortality plummeted with the advent of inoculations and improved
sanitation. Finally, as Paul Starr reminds us in "The Social
Transformation of American Medicine," it is unlikely that good
statistics on mortality will be found for all of America: "America was
the country where classical liberalism had most thoroughly shaped the
relations between state and society. As of 1900, American government
was highly decentralized, engaged in little direct regulation of the
economy or social welfare, and had a small and unprofessional civil
service...Congress had set up a system of compulsory hospital insurance
for merchant seamen as far back as 1798 (following European
precedents), but this was an altogether exceptional measure to deal
with a group that was commercially and epidemiologically strategic
because of its role in foreign commerce. Congress approved aid to
mental hospitals in 1854, only to see the bill vetoed by President
Pierce. It created a National Board of Health in 1879, but abolished
it in 1883. In two stages in 1902 and 1912, it expanded the Marine
Hospital Service into the U.S. Public Health Service but gave it few
functions and little authority. The federal government continued to
leave such matters to state and local government, and the general rule
at those levels was to leave as much to private and voluntary action as
possible." p.240
Thus it is unlikely that meaningful comparisons can or ought to be made
between your chances of dying from this or that in say 1906 and today.
David Ritchie,
Portland, Oregon
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