New Issue of Social History of Medicine

The most recent issue of Social History of Medicine contains several articles are related to the history of psychiatry.

Titles, authors and abstracts are listed below.

Capacity to Marry: Law, Medicine and Conceptions of Insanity by Ezra Hasson (School of Law, Law and Social Sciences Building, University of Nottingham). The abstract reads:

Historically, English law has not constructed insanity as intrinsic to the individual, but rather as something to be determined by his or her abilities within the context of a particular situation. The courtroom provides the most visible forum within which the discourses of law and medicine interact, and yet the civil law context has been left largely unexamined by historians of madness. This paper seeks to begin to address that gap, through an examination of court cases determining competency in marriage. Using primarily nineteenth-century cases—claiming nullity of marriage on the basis that one party was insane and thus unable to give valid consent to the marriage contract—it explores how this ‘compartment’ of insanity is conceptualised.

Childhood Sexuality, Normalization and the Social Hygiene Movement in the Anglophone West, 1900–1935 by R. Danielle Egan (Gender and Sexuality Studies Program, St Lawrence University) and Gail Hawkes (School of Cognitive and Behavioural Sciences, University of New England). The abstract reads:

Analysing primary materials from the USA, England and Australia, this paper explores the discursive production of childhood sexuality within the social hygiene movement. Attempts to shape and tame ‘the native capacities’ of impoverished children into socially acceptable, monogamous heterosexuals functioned as a central tenet of sexual hygiene reform. Habituation provided the pedagogical entry point for hygiene’s normalising project. The paper concludes that the body of the child functioned as the rationale through which the proliferation of the increasingmanagement of both the individual and the population was rendered credible within sexual hygiene narratives.

Criminal Propensities: Psychiatry, Classification and Imprisonment in New York State 1916–1940 by Stephen Garton (Department of History, University of Sydney). The abstract reads:

This article investigates the introduction of psychiatric classification into the New York penitentiary system from 1916 (when the first clinic was established) till 1940. It focuses on the growing influence of theories of psychopathology and personality disorder in the understanding of criminality and maps their impact by a close reading of individual case files. In doing so it argues that, while the language of psychiatry held powerful sway onparole board decisions, psychiatric diagnosis itself was heavily dependent on older technologies of social investigation arising out of practices of urban surveillance and social case work. Thus psychiatry had a significant influence within the penitentiary system but that influence was contingent upon the success of social analysis not psychiatric theory.

Useless Soldiers: The Dilemma of Discharging Mentally Unfit Soldiers during the Second World War by Nafsika Thalassis (University of Salford, European Studies Research Institute). The abstract reads:

During the Second World War, an unprecedented concern with the mental fitness of troops led to new selection procedures designed to ensure that soldiers possessed a certain level of intelligence and emotional stability. Using a variety of sources, including case notes from contemporary psychiatrists, this article explores two categories of soldiers who were up for discharge: those with ‘low intelligence’ and those with ‘inadequate personalities’. It suggests that many psychiatrists and combatant officers did not believe it was wise to retain the maximum number of soldiers in duty because many men were thought to be inherently incapable of becoming efficient soldiers.

Psychosurgery, Industry and Personal Responsibility, 1940–1965 by Mical Raz (Van Leer Institute, Jabotinsky 43, Jerusalem, Israel and Department of Internal Medicine J, Tel Aviv Sourasky Medical Center)

Between 1935 and 1965, tens of thousands of lobotomies were performed in the United States in an attempt to alleviate psychiatric disorders. This article focuses on the role that employment and the capacity to work played in framing the results of lobotomy in a positive light. It argues that employment status was a key factor in evaluating patients’ post-operative condition, and in determining the success of the operation. The article focuses on the publications and archive papers of Walter Freeman, the physician responsible for the widespread endorsement oflobotomy in the United States. The preoccupation of physicians and patients with the capacity to work, and the emphasis on productivity, industry and personal responsibility, were contributing factors to the success of lobotomy in the US. It is argued that the somatic intervention of lobotomy was based on, and reaffirmed, a social approach to mental illness.

Discovery and Management of Adverse Drug Reactions: The Nomifensine Hypersensitivity Syndrome, 1977–1986 by John Abraham  (Professor of Sociology and Director Centre for Research in Health and Medicine (CRHaM) and Courtney Davis (Lecturer in Sociology, Centre for Research in Health and Medicine (CRHaM), University of Sussex). The abstract reads:

Taking the antidepressant, nomifensine, this article focuses on the discovery and management of adverse drug reactions (ADRs) manifested in doctors’ spontaneous post-marketing reports. Company-friendly experts, free-lancer research scientists, public servant physicians and regulatory scientists are shown to have made distinct contributionsto ADR discovery. However, institutional and international fragmentation delayed synthesis of ADR reports into unambiguous discovery. Qualitative and quantitative interpretative standards of what counted as ADR discovery affected regulatory warning systems and decisions about when to withdraw a drug from the market. The timing and definition of an ADR as ‘irreversible’ or ‘rare’ was, in part, a function of the uncertainty and estimation criteria chosen by the party managing the discovery. UK regulators accepted relatively low levels of uncertainty, so the timing of discovery, warnings and regulatory action was relatively late, but US regulators chose higher thresholds ofuncertainty about discovery when interpreting the need to warn of suspected serious ADRs. The implications of these practices for the founding ideals of a post-marketing ‘early warning system’ are considered.

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