Disease is not a topic that has commonly been treated in detail by historians. Some historians have begun to give it more attention. Here Jeremy Diamond's Gun's, Steel, and Germs has powerfully persued the importance of disease in history. The modren threat of both bio-terrorism and the rapid movement of disease vectors as a result of modern communications has drawn further interest in the subject. We now know that the plague had a huge impact on modern Europe. We also know that smallpox and other diseases virtually wide out Native American populations. The topic is of some interest to HBC, both because of its important historical role, but also because of the role children have played in deceloping cures. One other interesting topic is the development of polio in the 20th century and the huge impact it had on children.
Disease is often a personal or family tragedy. Disease can have community impacts, but the histirical impact is often difficult to ascertain, especially before the modern era. There have been disease outbreaks, however, that have been so massive that the historical impact is obvious if not fully understood. Historians have normally mentioned disease only in passing. There is increasing evidence that disease at time has had a major impact on historical events. We have noted several different diseases that have had a major impact on history. The most obvious is the plague. We know most about the medieval plague epidemic in Europe. Presumably there were also outbreaks in China and the Middle East. With the European conquesrt of the Americas, smallpox had a huge impact on Native Americans. The desimation of Native American populations is one reason why small bodies of Europeans could destroy huge Native American esocieties. One historian maintains that disease is a major factor impeding the economic development of Africa. [Diamond]
Until the 20th century, people were very fearful of disease and people aflicted with disease. Of course one reason for this was that some diseases were contageous. This is understandable because no one really understood what caused disease. Many thought that disease was a sign that the individual was being punished by God or possessed by deamons--both good reasons for avoiding the affliced. ofen families were ashamed of children afflicted by disease or handicapped children. This became a major problem in the early 20th century when large numbers of children began to be struck by polio. Many of these children were institutionlized or essentially locked away by their families, kept from public outings and even school. Until the 20th century you never see political leaders in any way associated themselves with cripples, including children. The first who most powerfully began to change public attitudes was First Lady Eleanor Roosevelt in the 1930s.
The history of public health goes back to ancient times. It bemd a mztter of concern with the development of civilization. As cities developed, the concentration of population led to health problems that were generally avoided by hunter-gatherer peoples. At the time, disease and health were generally seen as the sork of the gods, although sime civilizatins began to lay the basis fir scientific work. The Egyptians learned a great deal, in prt bcause of their interest in embalming. They did not, however, begin to develp science. The Greeks dis and many modern sciences trace their hitory to Greek thinkers. China also discovered a great deal, but also did not lay the fojundation for scientific investigation. Modern public healt based on scientific understanding did not begin in a serious way until the 19th century. It is a this time that modern science began o reach a critical mass and it became possible to understand and treat many diseases. As a result, the impottance of public health and government support for a public health infrastructure began to emerge. The public and government officils began to appreciate the link between the environment, espcially the urban enviroment, and health. Scientists proved the germ theory and ways to protect people from infection. There was at first a laissez faire approach to health issues. Government issued few if any health regulations.
And as part of social reforms of the Victorian era. governments began a range of efforts to improve the health of the population. Industrialization had led to increases in urban population and this migration from rural areas to cities steadily increased during the 19th century. Many problems surfaced in Victorian Britain because the Industrial Revolution and the raid groth of cities began there. The British thus faced increasing problems with sanitation and overcrowding that lincreased the opportunity for serious disease outbreaks. At the same time modrn public health policies began to take shape. Britain set up the National Vaccination Board (1837). Social reformer and kawyer Edwin Chadwick (1800-1890) published his landmark work--"Report on the Inquiry into Sanitary Conditions of the Laboring Population of Great Britain (1842). Chadwick outlined the major public health challenges facing Britain which launched the reform process. While not a scientist or doctor, the central public health administration he championed promoted the ‘sanitary idea’. The agency assisted local authorities to build drains, sewers, street cleaning and the a range of environmental regulations. These addressed housing, nuisances, and offensive trades.Across the Atlantic, Lemual Shattuck (1793-1859) in Boston released his seminal report on public health (1850). Shattuck outlined the public health needs in the state of Massachusetts which were basically the needs of America writ large. He recommended the establisgment of a state board of health which would be the first in the nation.
Other than the diseases discussed above, there are several public health issues that particularly affect children. Some of these hve included head lice, ring worm, hook worm, and others. These are topics we have not yet addressed, but hope to do so. One counterintuitive developmnt as a result of the public health movement is the appeaeance of aews diseas affecting mosgly children--polio.
There are some health used that are cilturally based, income cases associated with religion. There have been instances of child sacrifice in history. This is brought to light most famously in the Bible with the story of Abraham and Issac. The Carthgenians are believed to have practiced child sacrifice on a large scale. This is a little difficult to assess because most of the written sources about Carthage are Roman, obviouly biased sources. The Roman found child sacrifice to be a particularly abhorent aspect of Carthwgibian life. We have also note child sacrifice by the Inca in the high Andes. Perhaps the most pronounced culturally based issue id femal genital mutilation in some areas of the Islamic world.
An important note here is the role of modern science in preventing these diseases. This of course is obvious. Less obvious is the image of modern science. When we began teaching school, I was surprised to find that science was amolng the least popular subjects with American students. I was suprised at this because as a boy I found science fascinating. We are not entirely sure why this was, but suspect teaching methods were a factor. Another observation is the image of science among young people. Given the fact hat scientists and inventors played a mjor role in building modern America, you would think scientists would have very positive images. But this is not the case. Here we suspect the popular media is a factor. To the extent that scientists appear in cartoons, movies, and television--the "mad" scientist is a very common character. Another media target is the drug companies, the same drug companies that have played major roles in treating diseases and other health problems. Here the issue is more complicated. It does seem unethical for drug companies to price medicines so that many can not aford them. The often left-leading media does a good job in posing this very real problem. The implication is that profits are bad. What the media does not present is the simple fact that virtually all important nedicines have come out of the private sector. It is difficult, for example, to name an important pharmaceutical developed by the Soviet Union or other Communist country. Nor have they been developed by Governments in other European countries.
The history of medical science is a fasscinating story. Even before the development of civilization, humans began to notice the medicinal properties of plants and substances. Several ancient authors addressed the topic, spcilly the Greek. But without scientific knowledge there was little they could do. Hippocrates of Kos (Hippocrates II) was a Greek physician of the Age of Pericles, is one of the most outstanding figures in the history of medicine. The Roman physician Galen (c129–199 AD) dominated Western medicine for centuries. During the medieval era it was the Islamic world that preserved and built on classical knowledge. Several scholars such as Ali ibn Sahl Rabban al-Tabari (860 AD) advanced medical knowledge. As the Islamic world turned away from science toward a narrow religious outlook, it would be the Christian West that would develop modern medical science. Bacterial disceases were the first to be addressed bcause bacteria, a least bacterial growths, could be observed. Bacteriology began after science had been invented in the West. Experimental work with began with many inportant scintific discoveries (17th century). Botanists and zoologists tried to structure and classify the world of the invisible living organisms (18th century). Bacteriology was established as the science of disease germs (1880s). The German physician Robert Koch brought the science of microorganisms moved into the realm of medicine. Viruses were more of a problem because they were so incredably small. The history of virology began somewhat later (late-19th century). Louis Pasteur and Edward Jenner developed the first vaccines to protect against viral infections, but they had no idea about the science behind their treatmets. They did not even know that viruses existed. The first evidence that viruses came from experiments with filters that had pores small enough to retain bacteria. Dmitry Ivanovsky used one of these filters to show that sap from a diseased tobacco plant remained infectious to healthy tobacco plants despite having been filtered (1892). Martinus Beijerinck called the filtered, infectious substance a 'virus' and this discovery was the launch of virology. The subsequent discovery and partial characterization of bacteriophages by Felix d'Herelle further catalyzed the field, and many viruses were discovered (early-20 th century). Unfortuntely this work was to limited to give scietists the tools needed to address the deadly flu epidemic at the end of World War I.
A range of disabilities affect children from an early age. Some are disabilities associated with birt defects. Others result from accidents or childhood diseases. The most obvious are sight and hearing impairments. Others are the loss or impairments of limbs affecting mobility and dexterity. Special schools were founded to address both hearing and sight impairment. An example in America is the Perkins School for the Blind. The idea at the time was to institutionalize the children and deal with them separately from other children. Modern approaches have been to mainstream the children if possible.
We have begun to collect information on specific disases. There are references to diseases in historical sources. Before the 19th centurty, however, it is not always possible to ascertain just what disease they were discussing. Historians have used the symtoms described to dertermine the disease, but often the sympthns are not described with adeqequate speficity. Some diseases affect the entire population. Other diseases specifically affect children, or more accurarely, children are more vulnerable to certain diseases. Here the most obvious is polio. In addition, the way to combat several endemic diseases in the innoculation of children which is done before they begin school.
Going to the hospital can be a scary experience for children. Just going to the doctor and getting a shock can be unpleasant enough, but the hospital can be a very different matter for younger children, if only for routine treatments.
A HBC reader has mentioned an interesting book written for children by Frances Chase, A Visit to the Hospital The illustrations are by James Bama.
The book is a story written for children who might need to go into hospital for surgery. In this story the boy is going into hospital to have his tonsils removed. We follow him being given a reassuring talk about going into hospital by his older brother. His parents help him pack his suitcase. He goes to the hospital dressed in his best short pants suit. That might have happened in 1957, it certainly wouldn't happen today. When he arrives at the hospital he meets a boy coming out who is also dressed in the same way. He meets the doctor and smiling nurses. He is dressed in hospital clothes. After the operation the boy comes home and he finds a presents. He opens it up and finds it’s the fire truck he always wanted. The drawings illustrate the experience of the young boy’s hospital visit. This story was written to reassure children about what will happen to them in hospital. Both the child, the parents and medical personnel know that this can be a scary experience. The child knows he is going to feel pain. His mum and dad are worried about the operation and have to leave their child behind who is suffering. They know they should be with him at this time. The doctors know that they will be able to heal the child quicker if the child is unafraid and comfortable and knows what the surgeon will do to make the child better.
Circumcision is both a religious and medical practice, both are today highly controversial. The origins of the practice are not well understood. Few practices have so many conflicting views as to its origins. Anthropologists passionately debate the origins of circumcision. One theory suggests that circumcision appeared in Heliolithic culture over (about 15,000 BC) before the development of agriculture and civilization. [Smith] From these origins in appeared in Middle Eastern and related cultures.
The other important theory is that circumcision developed independently by individual cultures. Circumcision historically was most prevalent in the Middle East and Africa. It was virtually unknown in China. In modern times it has been practiced in Europe and North America. The oldest evidence concernig circumcision comes from ancient Egyptian art work, although the images are suject to varying interpretation. Many Semitic peoples practiced circumcision. They may have been influenced by the Egyptians, but the origins are lost in time. Greek objections to the practiced descouraged the practice after Alexander's conquest throughout the Middle East. The original purpose of the practice is widely debated and is based largely on imaginative speculation. One suggestion is that it had religious origins as a sacrifice to the gods--presumably a fertility rite. There are many other suggestions, including a tribal mark, a rite of passage, a mark of masculinity, a way of demeaning captives or slaves, or as a hygienic measure. Modern circumcision in Europe and North America has debateable hygienic justifications. Circumcision also has ancient origins among many among several Sub-Saharan tribal groups where it is still practiced on adolescent boys as a rite of passage. It is unknown if it originated independently or was an Egyptian cultural influence. It is a Jewish religious practice and widely practiced in the Muslim Middle East. After the turn-of-the 20th century it became common in America as a neo-natal procedure, but it no longer a standard procedure. Circumcision is generally a practice associaled with boys, but there is a related practice some times ferred to as female circumcision which has more modern roots. It is widely practiced in the Nileotic region and the the the northern rim of sub-Sahsran Africa, It is most common among Muslims, but has not Koranic jusrification. It is often done in unhygienic procedures using crude implements. Both Islamic andcChristian religious figures have condemed it.
Smith, Sir Elliot. Important Egyptologist.
Diamond, Jeremy. Guns, Steel, and Germs
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