Long an interest of medical historians, the history of disease has recently been placed into more complex biological and social contexts. However, our growing specialization frequently inhibits and even denigrates the composition of broader, multidisciplinary narratives. Historicists insist that disease is merely a social construction, even questioning the scientific identification of particular diseases. Yet humans remain inextricably linked and shaped by surroundings while their actions decisively impact the chosen environment. For a fuller and global epidemiological picture, all frames—biological, social, cultural, political, and economic—must be integrated. Concerning the topic of yellow fever in the American South, most previous historical publications tended to concentrate primarily on the drama of epidemic outbreaks, their social, political, and economic impact, and their challenges to public health. Urmi Engineer Willoughby’s Yellow Fever, Race, and Ecology in Nineteenth-Century New Orleans, however, offers a broader environmental context, focusing on the multiracial populations of Lower Louisiana and particularly New Orleans. The city was a strategic hub for trade with the Caribbean and with South America, and its struggles with periodic outbreaks of this enigmatic, often lethal scourge are worthy of further analysis. The book is chronologically arranged, covering events from the 1600s to the present. A background chapter on the probable seventeenth-century origins of yellow fever in forested tropical Africa sets the scene. A viral disease endemic among primates in forests of West and Central Africa, this infection was transferred to humans by a variety of domestic mosquitoes. Subsequent transmission from West Africa to the newly colonized Caribbean islands occurred via the slave trade. Indeed, yellow fever found a favorable foothold in the New World’s sugar plantations, triggering periodic outbreaks in commercial ports such as Boston, New York, Philadelphia, and Charleston. Traditionally, this scourge offered a wide spectrum of clinical manifestations, ranging from mild flu-like symptoms to terrifying gastrointestinal and urinary bleeding, jaundice, and terminal organ failure. Survivors acquired lifetime immunity.

Using materials obtained from an unusually rich repository of documents pertaining to the Royal Infirmary of Edinburgh, this chapter illustrates both the nature and range of analyses possible in the history of hospitals. At the Edinburgh Infirmary, the admission of cases of venereal diseases declined significantly between the years 1770-1800, in part because proportionately fewer soldiers entered the hospital, but also because other ailments such as typhus fever, malaria, and rheumatism became more frequent. Data cited in the portion of the Edinburgh study were extracted from fourteen separate student casebooks containing a total of 808 complete cases from the years 1771 to 1799. Published statistics or annual reports, official regulations or statutes, and minutes of meetings held by hospital governing boards may be available in many instances. Important additions can be general registers of patients, admission and discharge lists, ward journals, prescription books, and apothecary inventories.

This chapter examines the connotations of “loathsomeness” in characterizing disease. By the nineteenth century, the term was most frequently mentioned for the immediate separation and isolation of individuals, owing to perceptions of epidemics in so-called civilized European and North American countries as tragic and transformative while deemed natural and cyclical in poor Asian and African populations. The use of this code word was deliberate; readily institutionalized by the medical profession, it was part of an emotional vocabulary designed to instill aversion. Loathsomeness implied a broad range of revolting feelings, from a physical disgust to moral contempt, fear to outrage and repulsion, horror to odium. Primarily intended to identify acute ailments with hideous skin manifestations, the attribution was also linked to ethical infringements.

This chapter documents the efforts of the nineteenth-century medical community in the search for better cures and means of treatment for patients suffering from loathsome diseases. Fuzzy professional ethics and ambiguous public sentiment came to guide physicians in their slow march toward modern therapeutics. The less risky approach of simply letting nature take its course collided with a growing desire to test new drugs at the bedside. Thus the chapter recounts the advances made in medical sciences in the slow march toward modern therapeutics, and also discusses the drawbacks of scientific research during this period. In their quest for new knowledge about disease, nineteenth-century physicians even periodically resorted to human experimentation.

Based primarily on personal experiences, this article aims to illustrate the troublesome relationship between the University of California, San Francisco (UCSF), and its adjoining neighborhoods from the 1960s to the present. Like other University of California campuses, UCSF was not required to conform to local land uses and zoning laws. Only its periodic and mandatory Long Range Development Plans provided clues about future research initiatives and expansion plans. The story, punctuated by indifference to neighborhood concerns, depicts the protracted legal wrangling between a world-renowned medical institution and local civic organizations fearful of its impact on the environment, residential life, and real estate. The featured focus of these disputes centered around UCSF's hasty purchase in 1984 of a large facility located in the Laurel Heights neighborhood of San Francisco to alleviate crowding at the main campus on Parnassus Heights. Confusion, misunderstanding, and outright distrust concerning UCSF's planning for the new research location ensued. In fact, fear of potential chemical emissions and radioactive contamination prompted stiff local resistance. Eventually, after a decade of litigation, the protracted case forced UCSF to redefine and restrict its mission at Laurel Heights. The article argues that the Medical Center's subsequent leadership learned an important lesson from this costly lawsuit. In its subsequent efforts to expand locally, UCSF created mechanisms designed to prevent opposition and litigation by systematically engaging with San Francisco communities and their leaders. By the early twenty-first century, such partnerships and alliances paved the way for a successful institutional expansion, thus consolidating UCSF's role as a leader in biomedical research, teaching, and practice.

2• THE FEDERAL LAWYER• March 2015 ization, barred voting, curtailed business and employment, and dehumanized in countless other ways. Popular sensational accounts of Chinatown’s depravity, filth, and unsanitary conditions made the decision to impose the quarantine seem clear. The Chinese Counsel, community leaders, and others protested. Kinyoun, speaking for the scientific and public health establishment, took the lead in explaining the necessity for the quarantine. The white business establishment was ambivalent. Eager that business continue as usual, they hesitated in their support. State politicians, especially the Republican governor, Henry T. Gage, decried the heavyhanded federal interference in what was a local affair. With the quarantine in place, the Chinese sought legal recourse. In early May 1900, they filed suit in federal court.

Reviewed by: Hospital Life: Theory and Practice from the Medieval to the Modern ed. by Laurinda Abreu and Sally Sheard Guenter B. Risse Laurinda Abreu and Sally Sheard, eds. Hospital Life: Theory and Practice from the Medieval to the Modern. Oxford, UK: Peter Lang, 2013. xvi + 335 pp. Ill. $81.95 (978-3-0343-0884-7). Twelve historical case studies illustrate the gradual transformations of an institution currently experiencing challenges to its dominant position in health care: the hospital. Like its 2007 predecessor, the collection contains papers from the 2011 conference organized by the International Network for the History of Hospitals created in 1995. The topic, hospital life, primarily features a detailed analysis of the external circumstances that shaped it: social, cultural, and economic. Such framing allows authors to present their contingent and richly documented accounts in a chronologically arranged manner from medieval times to the present. Life in a hospital is still shaped by the needs of sponsors and those sufferers permitted to enter. For the latter, cast among strangers, the sudden transition into an alien world with stricter rules and routines can still be shocking and disorienting. To achieve institutional order and communicate meaningful support, hospitals historically engaged in a variety of routines and rituals, beginning with regular, communal meals. As one essay concerned with a medieval English institution (Bonfield) attests, this “regimen” included spiritual support, nourishment, and clean clothing, all attempts to provide a measure of comfort and perhaps facilitate rehabilitation. But could these measures be considered “therapeutic”? The picture becomes clearer in subsequent centuries as medicine and nursing came to recast hospital functions in the face of new contagious diseases. Two chapters, one about patient care for syphilis in Lisbon’s Real Hospital (Arrizabalaga) and one about Florence’s Hospital of the Incurable (Strocchia), illustrate a willingness to exploit larger institutional populations for the acquisition of new medical knowledge—mercurial or guaiac therapy—and eventually training and education (Abreu). Another contribution is devoted to the financial management of an early modern hospital in Düsseldorf (Dross), exposing in great detail the primary goal of its private founders: ensure institutional continuity for their eternal salvation. For this purpose, keen business practices from real estate rents and crop and wine sales to annuities and mortgages all generated the income required for the upkeep of buildings, lodging, feeding inmates, and paying physicians’ visits. Later, as states assumed the responsibility of sponsoring and running hospitals, foundations such as the Infirmary of the Hotel des Invalides in Paris (Belmas) and Royal Lying-in Hospital in Copenhagen (Løkke) imposed their own social and therapeutic agendas to shape hospital life. By the eighteenth century, larger institutions, especially in metropolitan centers such as Paris and London, demanded a more rigid structuring of nursing and medical routines. Controlling working-class patients, forcing them into total [End Page 122] subordination and subjecting them to experimental treatments became the norm (Belmas, Tanner, and Hawkins). Lunatic asylums in Corfu and Malta, however, allowed for an “open gate” policy with family and friends visiting daily (Chircop). The New World is represented by an essay on slave hospitals in Augusta, Georgia, focused on a private pre–Civil War institution designed for the rehabilitation of individuals who were then viewed as valuable commodities (Kenny). Following accidents and obstetrical complications, the goal was to restore their “soundness,” particularly the capacity for labor and reproduction. Here again business and professional medical agendas were the primary drivers. Two important chapters address recent issues of cost containment and efficiency affecting the character and length of hospital stay. As twentieth-century establishments became expensive houses of technology, planning and architectural design sought to assist in streamlining their diagnostic and therapeutic functions in compact, assembly-line fashion (Theodore). “Traffic efficiency” (coded through colored lines and arrows) for a more economic movement of nurses, doctors, and patients—later supplemented by computers and robots, reshaped institutions into a “cybernetic healing machine.” Evermore shorter hospital stays compress hospital life; often domicile recovery follows overnight sojourns, even after invasive surgery. A close look at the background and shifting boundaries between active care and convalescence offers a fascinating glimpse into medical economics (Sheard). In sum, as the editors contend, this collection...

Twelve historical case studies illustrate the gradual transformations of an institution currently experiencing challenges to its dominant position in health care: the hospital. Like its 2007 predecessor, the collection contains papers from the 2011 conference organized by the International Network for the History of Hospitals created in 1995. The topic, hospital life, primarily features a detailed analysis of the external circumstances that shaped it: social, cultural, and economic. Such framing allows authors to present their contingent and richly documented accounts in a chronologically arranged manner from medieval times to the present. Life in a hospital is still shaped by the needs of sponsors and those sufferers permitted to enter. For the latter, cast among strangers, the sudden transition into an alien world with stricter rules and routines can still be shocking and disorienting. To achieve institutional order and …

316 pp. 6 9. 11 b & w photos. 2016. Paperback 978-0-252-08138-5. $30.00; E-book The Science of Sympathy Morality, Evolution, and Victorian Civilization ROB BODDICE “Exemplary. Boddice demonstrates that the culture of Victorian science changed irreversibly what sympathy could mean and how it could be felt. The book will be at the top of my list when people ask, ‘What does it look like when you do the history of emotions?’”—Daniel M. Gross, author of The Secret History of Emotion: From Aristotle’s Rhetoric to Modern Brain Science

Social forces have continually framed how hospitals perceive their role in care of the dying. Hospitals were originally conceived as places of hospitality and spiritual care, but by the 18th century illness was an opponent, conquered through science. Medicalization transformed hospitals to places of physical cure and scientific prowess. Death was an institutional liability. Equipped with new technologies, increased public demand, and the establishment of Medicare in 1965, modern hospitals became the most likely place for Americans to die—increasing after the 1940s and spiking in the 1990s. Medicare’s 1983 hospice benefit began to reverse this trend. Palliative care has more recently proliferated, suggesting an institutional shift of alignment with traditional functions of care toward those facing death.

History reveals that, in every society, people have suffered physical and emotional distress for which they promptly sought assistance from specific categories of individuals devoted to healing. Traditionally, the care of the sick has been an important societal arena, with knowledge, skills, institutions, and remedies perennially provided by and contested by several groups, from families and folk practitioners to professional physicians. Past healing schemes not only provided explanations and human resources for caring efforts, they also regularly furnished particular remedies and techniques designed to achieve recovery, thus helping the sick re-integrate into their communities. For historians interested in the phenomenon of healing, the fact of illness raises a number of important questions about the manner in which the sick have coped with pain and disability. Perhaps the first issue to be addressed is that of definition. What, for example, was meant by a fever? Why and by whom was this suffering categorized as sickness? Once a problem had been identified, what options were available to ameliorate it? Often, those who felt sick relied on themselves for help. A cold cloth on the forehead could perhaps stanch a fever. If that was not enough, the sick sought social organizations and resources that routinely handled their complaints. The final choice of healer and the negotiating process involved in this selection are equally important components of the therapeutic dynamic. Because of social, political, and economic determinants, healing is and has been a local expression of culture and society. Care continues to be a complex transaction involving a …