Saturday, November 27, 2010

Health Reform in 19th Century America

Ronald Numbers, Prophetess of health : Ellen G. White and the origins of the Seventh-Day Adventist health reform, Knoxville : University of Tennessee Press, 1992

Ellen G. White is one of four nineteenth-century founders of a major American religious sect (the others are: Joseph Smith - Mormon, Mary Baker Eddy - Christian Science and Charles Taze Russell - Jehovah’s Witnesses), but she is not widely known outside of her church.  Yet when she died in 1915 she left behind a legacy that consisted not only of the Seventh-day Adventist Church, but also sanitariums and hospitals located throughout the world.  She also inspired an educational system that is still highly regarded, traveled, lectured, and wrote dozens of books.  She was born Ellen Gould Harmon, along with her twin sister Elizabeth, on November 26, 1827.

Her influence sprang from the visions that she began experiencing in 1844, when she was seventeen.  These trances lasted anywhere from a few minutes to several hours, and during them she received messages about events both in the future and the past, heavenly and earthly.  These visions were accepted as genuine revelations from God, and her followers (with her encouragement) regarded her as a true prophetess on a par with the prophets of the Bible.

On June 5, 1863, in Otsego, Michigan, she received her vision regarding health, in which God revealed to her the hygienic laws that should be followed by Seventh-day Adventists.  They were to give up eating meat and other stimulating food, neither drink alcohol nor use tobacco, and avoid medical drugs.  When they were sick they were supposed to rely on the remedies of Nature, including fresh air, sunshine, rest, proper diet, exercise and water.  Women were to cease wearing the fashionable clothing of the time (including hoop skirts and corsets) and wear “short” skirts and pantaloons.  Followers were also supposed to curb their “animal passions” (masturbation was an especial evil leading to deformity of mind and body, not to mention spirit).

Health reform was not new.  In the early nineteenth century, America was not a healthy or hygienic place.  Americans ate too much meat and not enough vegetables and fruits.  Their food was heavy with grease and fats, and they drank too much Brazilian coffee.  Public sanitation was horribly inadequate, and personal hygiene wasn’t much better.  Most Americans seldom, if ever, bathed.

In the 1830s, Sylvester Graham launched a full-blown health crusade.  In the summer of 1830 the Pennsylvania Society for Discouraging the Use of Ardent Spirits invited him to come and lecture under its auspices.  He accepted and was soon giving lectures featuring his scientific and moral arguments against consumption of alcohol.  Reverend William Metcalfe was also preaching in Philadelphia at this time.  He was the author of the first American tract on vegetarianism and had brought his English congregation over in 1817 and established the vegetarian Bible Christian Church.  Graham added the vegetarianism to his lectures on temperance.  In 1831 he broke away from the Society and was lecturing at the Franklin Institute on a broad range of topics including proper diet and the control of the passions.  The 1832 cholera epidemic thrust Graham and his health reforms into the spotlight.

Another reformer, important partly because he was associated with the Millerites (as was Ellen White) and also because her reforms mirror many of his, was Larkin B. Coles.  His claim to health reform fame lie in two books: Philosophy of Health: Natural Principles of Health and Cure and The Beauties and Deformities of Tobacco-Using.  His view of health reform was a moralistic one, and was not unique among health reformers.  But both Cole and White saw obedience to these laws of health mainly as a requirement for entry into heaven rather than as a means for living a more enjoyable and healthy life on earth.

Saturday, November 13, 2010

Science as a Social Construct

Douglas, Mary.  “Environments at Risk” in Science in Context, Barry Barnes & David Edge, eds.  Cambridge, MA, MIT Press, 1982 (pp. 260-75)

Science in Context is a collection of essays focusing on the sociology of science.  The purpose of the collection, as stated in the General Introduction, is to “provide a tolerable indication of what is going on in the sociology of science, and, more importantly, of what kind of social activity science is, and what its significance is.”  The primary focus of the collection is on the relationship between the sub-culture of science and the wider culture that surrounds it, especially as it relates to science as a source of knowledge and competence and as a cognitive authority for evaluating knowledge claims.

Central to the ideas of sociology of science are the writings of Thomas Kuhn, especially his book The Structure of Scientific Revolutions.  From Kuhn, sociologists of science have concluded that science is a social construct, and that even statements of scientific fact have a conventional character.  Because it is constructed and not intrinsic to the natural world, they conclude that it cannot be self-sustaining, and if it cannot be self-sustaining in the sub-culture of science, then neither can it be self-sustaining in mainstream culture.  There is nothing in science that implicitly reveals its correctness and so its standing in society depends upon the degree of trust and authority with which society imbues scientists and institutions.

In her essay, Mary Douglas examines the issue of credibility in the context of the ecology movement.  She is concerned with how beliefs arise and how they gain support.  The approach she takes is of the anthropologist from Mars, an hypothetical being that is agnostic when it comes to beliefs about the Earth’s environment.  In her view this suspension of belief is what allows us to confront the fundamental question of credibility.  She asserts that civilizations throughout history have viewed their environments to be at risk, although the risks they identified were generally not the same, but she claims that all civilizations pin responsibility for the crisis in the same way.  The environment is put at risk by human folly, hate and greed.

In the present, however, we have an added factor: self-knowledge.  Because we can compare our beliefs with those of others we lose the filtering mechanism that those earlier civilizations possessed.  We no longer have anything to restrict our perception of the sources of knowledge.  Credibility is easier in a limited belief system, but how do you determine credibility when opposing sides of an issue both make sense?  This is the question confronting environmentalists in our age.

Through various anthropological examples she endeavors to show that the credibility of a belief regarding how the environment will react to human action depends upon the moral commitment of the community to a particular set of institutions.  For example, bison do not like fratricide (murder within the tribe), so such an act endangers the well-being of the tribe and as a result has special sanctions.  So long as the institutions in question maintain the loyalty of the community, nothing can overthrow the beliefs that support those institutions.  If those institutions lose the support of the community, she claims that the beliefs are easily changed.  A particular view of the universe and the society holding that view are thus interdependent.  They form a single system and neither can exist without the other.  Any given environment that we know thus exists as a structure of meaningful distinctions.

In this credibility debate the role of laymen and social scientists is to examine the sources of our own bias.  Because we lack the moral consensus that gives credibility to ecological warnings we do not listen to the scientists.  Similarly, because we lack a discriminating principle we are easily overwhelmed by our pollution fears.  This discriminating principle comes from social structures and it allows a culture to select which dangers it will fear and also to set up a belief system that will address those dangers.  Without that structure we are prey to every dread and right and wrong cease to exist.  This is the price of full self-consciousness, but it is a price that she feels we must pay.  When we do that the classifications of social life will be gone and we will recognize that every environment is simply a mask and support structure for a certain kind of society.  Understanding both the nature and value of that society is as important as understanding the sources and nature of the pollution that puts our environment at risk.

Mary Douglas deliberately picks an area of science where our understanding is incomplete and in which the debate over competing theories has become politically charged.  Consensus is not the final arbiter of a scientific theory or hypothesis.  Unfortunately in the case of the environment politicians and advocates have created a situation where that is the level at which the discussion of the various theories and hypotheses is taking place.

Monday, November 1, 2010

Michael Kater, "Doctors under Hitler", Chapel Hill: University of North Carolina Press, 1989.

This monograph is a sociohistorical study of the medical profession under the Third Reich and rests on the author’s previous work analyzing doctors and medicine from Wilhelm II to Hitler.  It draws upon documents in the Federal Archive of Koblenz and the Berlin Document Center.  Primary material was also drawn from the student archive in Würzburg and other regional West German archives.  He also drew on the papers of the former panel physicians’ association, the KVD, as well as the predominant professional journals and memoirs of physicians that lived beyond 1945.

 At the dawn of the Third Reich, in 1933, there was a surplus of physicians, inherited from the republican era.  These doctors were at first hopeful that the new regime would address issues left over from the health administration of the Weimar Republic, but their hopes were not fulfilled.  Under the republic medical graduates had to spend three years as an assistant in a hospital where they were poorly paid, and forbidden to seek other sources of income.  Establishing themselves as independent practitioners was almost impossible for a doctor straight out of medical school.  One of the complaints lodged by spokesmen for this group was that medical institutions should stop advertising junior positions for bachelors only.  They also emphasized that, after public school teachers, high school teachers, and jurists, they represented the fourth largest group of academically trained professionals born after 1900.

 But under the Third Reich, the medical profession became a microcosm of the larger Nazi sociopolitical system, governed by the Nazi leadership principle and redefined in National Socialist terms.  Physicians now had to present every private contractual arrangement to the Reich Physicians’ Chamber for approval, register with the Nazi medical agencies and keep them informed of any changes in their family status or medical qualifications.  They also had to report on their patients.  All serious cases of alcoholism, ‘incurable’ hereditary or congenital illness (i.e. imbecilism) and highly contagious diseases such as venereal disorders were recorded and reported to the appropriate authority.

 The doctors themselves were required to undergo continued training.  Partly this was to break down the distinction between general practitioners and medical specialists, but it was also to teach them National Socialist concepts of health and medicine.  The unpopularity of these courses was perhaps offset by another change in their profession implemented by the Nazi legislators, its redefinition.  By stating that the medical occupation was not a business, the Reich Physicians’ Chamber was able to exclude anyone who was not properly schooled or licensed.

 This did not do away with medical quacks, however, for the Nazi conception of medicine favored the lay element over ‘school’ medicine.  Instead they created a new class titled “physician of natural healing” open to anyone who could demonstrate the requisite ability.  Anyone in this group with extraordinary talent could enter a medical facility without the usual professional medical qualification, and could even receive a license as a doctor medici.  The Nazis further required that regular doctors had to assist registered lay healers at the latter’s request.

Under the Third Reich medicine became the preeminent academic discipline, with approximately 30 percent of all university faculty being composed of medical teachers by 1935.  Medical faculty also became dominant in university power politics.  Between 1933 and 1945 the percentage of medical faculty serving as rectors increased from 36 to 59 percent.  Along with this increase in power and significance there was the establishment of a new discipline that became a part of the medical curriculum after 1933, Rassenkunde or Rassenhygiene, race hygiene or eugenics.  This ‘science’ consisted of three parts: anthropological, sociological, and medical, and its goal was to improve the superior race, while eliminating the inferior ones.

Kater thus links the professionalization of medicine in the Third Reich with its corruption.  West German doctors saw these events as a struggle between the forces of freedom and democracy against the totalitarianism of the Nazi regime.  A battle which the latter eventually won.  East German doctors, on the other hand, saw these events as the result of a premeditated conspiracy between fascist-minded German doctors and Nazi political leaders.  Kater feels that the truth is somewhere in between, but that it lies closer to the East German perspective, than the West German one.