TRANSFORMATIONS IN MEDICINE
AND HEALTH, 1865-1940

From: http://www.ferris.edu


After the Civil War the U.S. was one of the worlds great industrial and political powers. However, medicine is still largely ineffective in both organization and therapies with different groups extremely hostile to one another.

Health care is centered in the individual practitioner, not the institution and not the science.

Health environments:

Rapacious exploitation of the Gilded Age Robber Barons.

Problem of Transients: America has always been a nation of transients.

Improved transportation broadens medical options for everyone. After 1870 slow development of health and safety laws.

Workmen's Compensation

The earliest compulsory accident-insurance law was that enacted by Germany in 1884; Great Britain followed in 1897, and the U.S. in 1908.

The commission idea; workman's compensation. John R. Commons and Richard T. Ely.

Hospitals become prominent feature of later 19th early 20th century city.

Mental hospitals flourish

Tuberculosis sanitarium

In 1884 the American physician Edward Livingston Trudeau, who was also afflicted with tuberculosis, established the Trudeau Laboratory in Saranac Lake, New York. It became a model sanitarium, the kind that for many years was the mainstay of tuberculosis treatment.

NURSING REFORM.

Influence of Florence Nightingale(1820-1910), British nurse, hospital reformer, and humanitarian.

Nurses training schools set up 1870s. By 1900 there are 400.

Despite improvements hospitals did not reduce mortality until the end of the 1930s, when the sulfa drugs began to become available.

HOSPITAL EXPANSION

A Revolution in Medical Sciences

POST CIVWAR AMERICANS STUDY IN EUROPE

William Welch. Johns Hopkins

William Henry WELCH (1850-1934) Ed. B.A., Yale, 70; M.D. College of Physicians, Columbia, 75; extensive post-graduate work in Europe. Advisory council of the American Eugenics Society, 1923-30.

Welch was quite active in the eugenics movement. He was a founding member along with Alexander Graham Bell and Charles Davenport of the Eugenics Record Office. Welch served on the original committee of Scientific advisors to the Eugenics Record Office from 1912 to 1918. He was interested enough in world population problems to travel to Geneva for the organizing meeting of the International Population Union.

Welch became known as one of America's leading advocates of the newer bacteriology of the Koch school. Among his students were Simon Flexner and Walter Reed. Welch was one of the guiding lights of the Johns Hopkins Medical School. He served as dean from 1893 to 1898 and as chairman of the department of pathology between 1889 and 1916. He was also Director of the School of Hygiene and Public Health between 1916-26; professor of the history of medicine between 1926 and 30; emeritus after 1930.

Source: Mehler, History of the American Eugenics Society, Part II, Prosopography (University of Illinois, 1988)

ROCKEFELLER INSTITUTE FOR MEDICAL RESEARCH. 1903.

Gospel of Wealth: Carnegie, Rockefeller

The rise of bio-chemistry: physiologist

Jacques Loeb, (1859-1924), German physiologist, born in Mayen, and educated at the universities of Munich and Strasbourg. At the age of 32 he immigrated to the United States and taught at Bryn Mawr College, the University of Chicago, and the University of California. In 1910 he became director of the division of experimental biology at the Rockefeller Institute for Medical Research (now Rockefeller University) in New York City.

Loeb's researches were conducted under the theory that life processes and behavior should be studied as physical and chemical reactions. Working on the "instincts" of lower invertebrates, Loeb showed that many behavior patterns were responses of the "whole organism" to chemical changes in the environment produced by sunlight, heat, or electrical energy (tropisms). He was successful in artificially fertilizing the eggs of sea urchins and frogs with chemical solutions so that live young were born.

"Loeb, Jacques," Microsoft (R) Encarta. Copyright (c) 1994 Microsoft Corporation. Copyright (c) 1994 Funk & Wagnall's Corporation.

Walter Bradford Cannon, (1871-1945), American physiologist, known for a series of experimental investigations into the process of digestion, the nervous system, and the body's self-regulating mechanisms.

Cannon began his investigations in 1896, a year after German physicist Wilhelm Roentgen discovered X rays. Cannon used X rays to observe the process of digestion in laboratory animals. Using an instrument called a fluoroscope, he watched the progress of food and waste through the body. During these experiments, Cannon noticed that when an animal was under stress, its digestive processes halted. This led him to wonder about the body's response to danger, fear, and trauma.

Using mainly surgical and chemical means, Cannon investigated the response of the heart, the sympathetic nervous system, and the adrenal gland to unnatural circumstances. Cannon also studied the body's self-regulating mechanisms, which tend to maintain what he called homeostasis—that is, a constancy of internal conditions such as temperature, fluid levels, and chemical composition of blood and tissue.

Cannon, Loeb and others broke down the division between chemistry and biology and eventually organized the field of bio-chemistry, an entity which quickly acquired its own journals, societies, and specialties.

Botany was abandoned as the nineteenth century progressed. In place of plant remedies, bio-chemist turned more to metallic substances and compounds.

American drug manufacturers expanded in the 19th century.

Research and development did not become prominent until after 1920; although some r&r began as early as 1900.

World War I saw the breakup of the German Chemical monopoly.

PSYCHOLOGY REPLACES PHRENOLOGY AND CRANIOMETY

World War I IQ tests puts American Psychology on the map.

Leaders in psychology: Edward B. Tichener; John B. Watson; Edwin Boring.

Watson, John B. (1878-1958), American psychologist, professor of psychology and director of the psychological laboratory at Johns Hopkins University from 1908 to 1920. Founder of "Behaviorism," which restricts psychology to the study of objectively observable behavior and explains behavior in terms of stimulus and response.

American Neurology: Civil War vets provided impetus to study severe conditions of stress in vets.

Hall, G. Stanley (1844-1924), American psychologist and educator, named president of the newly founded Clark University in Worcester, Massachusetts in 1889. Hall was instrumental in the development of the new science of educational psychology. He was influenced by the American philosopher, William James. In 1887 Hall founded the American Journal of Psychology.

HEREDITY AND GENETICS:

Another of this country's changing scientific fields, that of heredity and genetics, was equally affected during this period of social considerations and imperatives.

Leading geneticists:

Morgan, Thomas Hunt (1866-1945), American biologist and geneticist, who discovered how genes are transmitted through the action of chromosomes, confirming the laws of heredity of the Austrian botanist Gregor Mendel and laying the foundation for modern experimental genetics. In 1933 Morgan won the Nobel Prize for physiology or medicine.

Eugenics, outgrowth of the study of human heredity, aimed at "improving" the genetic quality of the human stock developed in the second half of the 19th century. Underlying this interest in eugenics were two widespread philosophical convictions: a belief in the perfectibility of the human species and a growing faith in science as the most dependable and useful form of knowledge. One 19th-century predecessor of 20th-century eugenics was the group of sociological theories known as social Darwinism. The favorite catchwords of social Darwinism—"struggle for existence" and "survival of the fittest"—when applied to humans in society, suggested that the rich were better endowed than the poor and hence more successful in life. The continual and natural sorting out of "better" and "worse" elements would therefore lead to continued improvement of the species.

Many organizations devoted to eugenic purposes arose around the world, but the movement was especially strong in England, the United States, and Germany between 1910 and 1940. From the outset the movement was closely associated with a sense of white Anglo-Saxon superiority. In the U.S. the dean of the eugenics movement was Charles B. Davenport, who was primarily responsible for organizing the Eugenics Record Office in Cold Spring Harbor, New York.

The eugenics movement exerted considerable influence on popular opinion and was reflected in some state and federal legislation. Between 1911 and 1930, 24 states passed sterilization laws aimed at various social "misfits": the mentally retarded, criminals, and the insane. Laws were also passed restricting marriages between members of various racial groups. The key triumph of the U.S. eugenics movement came in 1924, when a coalition of eugenicists and some big-business interests pushed through the Johnson Act, severely limiting immigration into the U.S. from eastern European and Mediterranean countries. Eugenicists claimed that these immigrants were inferior to Anglo-Saxons and were "polluting" the "pure" American bloodstream.

Galton, Sir Francis (1822-1911), British scientist, considered the founder of the science of eugenics.

Galton, a cousin of Charles Darwin, became interested in heredity and the measurement of humans; he collected statistics on height, dimensions, strength, and other characteristics of large numbers of people. He devoted special attention to fingerprints and devised a method of identification by fingerprinting. He also demonstrated fundamental techniques in statistical measurement, notably in the calculation of the correlation between pairs of attributes.

Davenport, Charles Benedict (1866-1944), American zoologist and eugenicist, who was an important figure in establishing statistical methods in biology and in applying such methods to the problems of heredity. He also sought to apply these ideas to the improvement of the human race through eugenics.

Born in Stamford, Connecticut, Davenport attended the Polytechnic Institute of Brooklyn and was trained as a civil engineer. He then attended Harvard University, where he received a bachelor's degree in 1889 and a Ph.D. degree in zoology in 1892. Davenport taught at Harvard until 1899, the year he published Statistical Methods With Special Reference to Biological Variation, based on the approaches to biological statistics developed by the British mathematician Karl Pearson. Davenport was a professor at the University of Chicago from 1899 to 1904, leaving that position to become the full-time director of the Station for Experimental Evolution at Cold Spring Harbor, New York, where he had directed a summer teaching program since 1898.

Based on an analysis of patterns of human inheritance, Davenport argued that not only physical characteristics but also behavioral characteristics, such as an inclination to be dishonest or poor, were the products of heredity. Like many eugenicists before World War II (1939-1945), he urged limitations on immigration into the United States of populations he believed to be inferior; the prohibition of interracial marriages; and careful consideration of who should be encouraged to reproduce and who should be discouraged, or prevented, from doing so. Davenport published these ideas in Heredity in Relation to Eugenics (1911).