Disease and Society in America

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Abstract/Syllabus

Courseware/Lectures

Test/Tutorials

Disease and Society in America

Fall 2005

More than two-thirds of emerging human diseases have animal origins. (Image courtesy of U.S. Geological Survey.)

Course Highlights

This course features lecture outlines as well as extensive study guides in the the study materials section.

Course Description

This course examines the growing importance of medicine in culture, economics and politics. It uses an historical approach to examine the changing patterns of disease, the causes of morbidity and mortality, the evolution of medical theory and practice, the development of hospitals and the medical profession, the rise of the biomedical research industry, and the ethics of health care in America.

Syllabus

Description

The balance between health and disease is a central feature of human life and society. Over the past 500 years there have been major changes in the prevalence and experience of diseases, from epidemics of smallpox and tuberculosis, to the chronic afflictions of obesity, heart disease, and mental illness. At the same time there has been enormous growth in the role of medicine in culture, economics, and politics. Health care is now a major sector of the American economy and it will certainly be a dominant political issue for the 21st century. This course will use a historical approach to explore the changing interactions between disease and society in America, examining: changing patterns of disease, the causes of morbidity and mortality, the evolution of medical theory and practice, the development of hospitals and the medical profession, the rise of the biomedical research industry, and the ethics of health care in America.

Requirements

As a HASS-CI course, emphasis is placed on oral and written communication. The course thus requires:

Active participation in both lectures and weekly recitation sections.
A series of written assignments.

Recitation Sections

Each week's readings must be read prior to recitation section. Active participation in the discussions is required. Each student will also co-lead one section. This will involve:

Emailing the other members of the section in advance with a list of likely discussion topics.
Providing a 5-10 minute summary of the readings.
Leading the discussions (with help from the section leader).

Weekly Writing Exercises

There will be a short (200 words or less) writing assignment for each week. The assignments will develop specific reading and writing skills. They must be submitted prior to section each week.

Papers

Three papers are required, for a minimum of 20 pages total. As a HASS-CI class, one of these papers must be rewritten and resubmitted.

Grading

Each of the six requirements (section participation, weekly assignments, three papers, one rewrite) will be weighed equally.

Calendar

Recitation sections meet for one hour each week. They are not included in the course calendar.

Course calendar.
Lec #	TOPICS	READINGs AND PAPERS	KEY DATES
1	Introduction: Disease, Medicine, and Society
Part 1: Changing Patterns of Health and Disease
2	Health and Disease Before Columbus	Trans-Atlantic Epidemiology
3	Virgin Soil Epidemics
4	The Health of Colonists	Health and the Environment
5	Disease and the Environment
6	Urbanization and Public Health	Urbanization and Health
7	The Decline of Tuberculosis
8	Epidemiological Transitions and Health Disparities	Epidemiological Transitions
9	The Determinants of Health and Disease
10	Debate: Disease History and Health Policy		Paper 1 due
Part 2: Medicine and Society
11	American Indian Medicine	Colonial Therapeutics
12	Colonial Medical Theory and Practice
13	Inocutation and Vaccination	Medicine in the 18th century
14	Self Help and Heroic Medicine
15	Medical Education	Creating a Medical Profession
16	The Rise of Hospitals		Paper 2 due
17	Race, Gender, and Medicine	Scientific Racism/Sexism
18	Psychiatry and Mental Health
Part 3: The Rise of Modern Medicine
19	Anesthesia and the Rise of Surgery	Therapeutic Revolutions
20	Germ Theory and the Therapeutic Revolution
21	Public Health Politics I: Plague in Chinatown		Paper 3 due
22	Medical Technology and the Modern Hospital	Medical Technologies
23	Specialization and Medical Education
24	Public Health Politics II: HIV/AIDS	Public Health Revisited
25	Health Care Policy: Access and Cost
26	Disease and Society in the 21st Century		Paper 4 due

Readings

Texts

Rosenberg, Charles. The Cholera Years. Chicago, IL: University of Chicago Press, 1968 , 1987. ISBN: 9780226726793.

Ulrich, Laurel Thatcher. A Midwife's Tale. New York, NY: Knopf, 1990. ISBN: 9780394568447.

Starr, Paul. The Social Transformation of American Medicine. New York, NY: Basic Books, 1984. ISBN: 9780465079353.

Readings by Session

Course Readings.
Lec #	Topics	READINGS
1	Introduction: Disease, Medicine, and Society
2-3	Trans-Atlantic Epidemiology	Las Casas, Bartolomé de. The Devastation of the Indies: A Brief Account (1552). Translated by Herma Briffault. Baltimore, MD: Johns Hopkins University Press, 1992, pp. 27-47. ISBN: 9780801844300. Leon-Portilla, Miguel, ed. The Broken Spears: The Aztec Account of the Conquest of Mexico (1528?). Boston, MA: Beacon Press, 1992, pp. 70-102. ISBN: 9780807055014. Crosby, Alfred W. "Conquistador y Pestilencia." In The Columbian exchange; biological and cultural consequences of 1492. Westport, CT: Greenwood Pub. Co., 1972, pp. 35-63. ISBN: 9780837158211. Jones, David S. "Virgin Soils Revisited." William and Mary Quarterly 60 (October 2003): 703-742.
4-5	Health and the Environment	Wood, William. New England's Prospect (1634). Edited by Alden T. Vaughan. Amherst, MA: University of Massachusetts Press, 1977, pp. 25-31. ISBN: 9780870232268. Flint, Timothy. The History and Geography of the Mississippi Valley. To Which is Appended A Condensed Physical Geography of the Atlantic United States, and The Whole American Continent. 3rd ed. Vol I. Cincinnati, OH, E. Flint, MI, and Boston, MA: Carter, Hendee, and Co., 1833, pp. 35-40, 199-201, 223-224, 298-299, 331, and 407-408. Kupperman, Karen Ordahl. "Fear of Hot Climates in the Anglo-American Colonial Experience." William and Mary Quarterly 41 (1984): 213-240. Valencius, Conevery Bolton. "The Geography of Health and the Making of the American West: Arkansas and Missouri, 1800-1860." In Medical Geography in Historical Perspective. Edited by Nicolaas A. Rupke. London, UK: Wellcome Institute Trust for the History of Medicine, 2000, 2001, pp. 121-145. ISBN: 9780854840724.
6-7	Urbanization and Health	Pernick, Martin S. "Politics, Parties, and Pestilence: Epidemic Yellow Fever in Philadelphia and the Rise of the First Party System." William and Mary Quarterly 29 (October 1972): 559-586. Rosenberg, Charles E. The Cholera Years: The United States in 1832, 1849, and 1866 . Chicago, IL: University of Chicago Press, 1968, pp. 2-98. ISBN: 9780226726793.
8-9	Epidemiological Transitions	Omran, Abdel R. "The Epidemiologic Transition: A Theory of the Epidemiology of Population Change." Milbank Memorial Fund Quarterly 49 (October 1971): 509-538. McKinlay, John B., and Sonja M. McKinlay. "The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century." Milbank Memorial Fund Quarterly (Summer 1977): 405-428. Marmot, Michael G. "Social Differentials in Health Within and Between Populations." Daedalus 123 (Fall 1994): 197-216. Wilkinson, Richard G. "The Epidemiological Transition: From Material Scarcity to Social Disadvantage?" Daedalus 123 (Fall 1994): 61-77.
10	Debate: Disease History and Health Policy
11-12	Colonial Therapeutics	Josselyn, John. New-England's Rarities: Discovered in the Birds, Beasts, Fishes, Serpents, and Plants of that Country [1672]. Edited by Edward Tuckerman. Boston, MA: William Veazie, 1865, pp. 31-35, 48-55, 71-84, and 151. Heckewelder, John. An Account of the History, Manners, and Customs of the Indian Nations, Who Once Inhabited Pennsylvania and the Neighbouring States. Philadelphia, PA, 1819, pp. 221-244. Ulrich, Laurel Thatcher. A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812. New York, NY: Alfred A. Knopf, 1990, pp. 1-71. ISBN: 9780394568447.
13-14	Medicine in the 18th century	Blake, John B. "The Inoculation Controversy in Boston, 1721-1722." New England Quarterly 25 (1952): 489-506. Buchan, William. Domestic Medicine Or, A Treatise on the Prevention and Cure of Diseases By Regimen and Simple Medicines. Exeter: J. B. Williams, 1785. Excerpts: Preface, Introduction, Diseases of the Studious, Knowledge and Cure of Diseases, Consumptions, Smallpox & Inoculation, Bleeding. A full text version of Domestic Medicine is available. Kopperman, Paul. "'Venerate the Lancet': Benjamin Rush's Yellow Fever Therapy in Context." Bulletin of the History of Medicine 78 (2004): 539-574.
15-16	Creating a Medical Profession	Louis, Pierre. Rechearches on the Effects of Bloodletting in Some Inflammatory Diseases. Boston, MA: C.G. Putnam, 1836, pp. 1-23, and 55-71. Drake, Daniel. Practical Essays on Medical Education and the Medical Profession in the United States. Cincinnati, OH: Roff and Young, 1832, pp. 5-19, and 45-59. Starr, Paul. The Social Transformation of American Medicine. New York, NY: Basic Books, 1984, pp. 30-59, and 79-112. ISBN: 9780465079353.
17-18	Scientific Racism/Sexism	Clarke, Edward H. Sex in Education; or, A Fair Chance for Girls. Boston, MA: James R. Osgood and Company, 1874, pp. 31-39, and 76-85. Jackson, Mercy Bisbee. "Sex and Education." In Sex and Education. Edited by Julia Ward Howe. A Reply to Dr. E. H. Clarke's Sex in Education. Boston, MA: Roberts Brothers, 1874, pp. 150-163. Jones, D. S. Rationalizing Epidemics: Meanings and Uses of American Indian Mortality since 1600. Cambridge, MA: Harvard University Press, 2004, pp. 118-144. ISBN: 9780674013056. Brandt, Allan M. "Racism and Research: The Case of the Tuskegee Syphilis Study." Hastings Center Report 8 (1978): 21-29.
19-20	Therapeutic Revolutions	Pernick, Martin. "The Calculus of Suffering in 19th-Century Surgery." Hastings Center Report 13 (April 1983): 26-36. "Discussion on the Advisability of the Registration of Tuberculosis." In Transactions of the College of Physicians 16. Philadelphia, PA, 1894, pp. 1-27. Leavitt, Judith W. "'Typhoid Mary' Strikes Back: Bacteriological Theory and Practice in Early Twentieth-Century Public Health." Isis 83 (1992): 608-629. Warner, John Harley. "From Specificity to Universalism in Medical Therapeutics: Transformation in the 19th-Century United States." In Sickness and Health: Readings in the History of Medicine and Public Health. Edited by Judith Walzer Leavitt and Ronald L. Numbers. 3rd ed. Madison, WI: University of Wisconsin Press, 1997, pp. 87-101. ISBN: 9780299153243.
21	Public Health Politics I: Plague in Chinatown
22-23	Medical Technologies	Carhart, J. W. "The Clinical Thermometer." Medical and Surgical Reporter 72 (1895): 119-121. Herrick, James B. "Modern Diagnosis." Journal of American Medical Association 92 (February 1929): 518-522. Evans, Hughes. "Losing Touch: The Controversy over the Introduction of Blood Pressure Instruments into Medicine." Technology and Culture 34 (October 1993): 784-807. Greene, Jeremy. "Releasing the Flood Waters: Diuril and the Transformation of Hypertension." Bulletin of the History of Medicine 79 (Winter 2005). (Forthcoming) Beecher, Henry K. "The Powerful Placebo." JAMA 159 (December 24, 1955): 1602-1606.
24-25	Public Health Revisited	Treichler, Paula. "AIDS, Homophobia, and Biomedical Discourse: An Epidemic of Signification." Cultural Studies 1 (October 1987): 263-305. Specter, Michael. "Higher Risk." New Yorker 81 (23 May 2005). (Web version) Jones, D. S., and A. M. Brandt. "AIDS, Historical." In Encyclopedia of Microbiology. Edited by Joshua Lederberg. 2nd ed. Vol 1. San Diego, CA: Academic Press, 2000, pp. 104-115. ISBN: 0122268016. Brandt, Allan M. "The Cigarette, Risk, and American Culture." Daedalus 119, no. 4 (Fall 1990): 155-176.
26	Disease and Society in the 21st Century