The laryngoscope and nineteenth-century British understanding of laryngeal movements

The source of the human voice is obscured from view. The development of the laryngoscope in the late 1850s provided the potential to see the action of the vocal folds during speaking for the first time. This new instrument materially contributed to the understanding of vocal fold neuroanatomy, neurophysiology, and neuropathology. The laryngoscope led to elaborated understanding of disorders that previously were determined by changes in sound. The objective of this paper is to detail the consequences of this novel visualization of the larynx, and to trace how it aided in the development of understanding of the movements of the vocal folds. This is demonstrated through an examination of the activities and practices of a group of London clinicians in the second half of the nineteenth century.

Reading Photography in French Nineteenth Century Journals

This article explores how photographs published in the French medical and, to some extent, the popular press helped readers to interpret expressions and gestures as signs of emotional states, morbid conditions and physiological and psychological processes. The first two sections examine the use of photography to visualise normal and pathological bodies through measurements and experiments in the medical press, particularly Nouvelle Iconographie de la Salpêtrière, Archives de Neurologie and L'Année Psychologique. The next two sections study how the development of new photographic processes such as the magnesium flash and chronophotography created new conditions in which the body could be visually scrutinised in the medical press as well as popular journals such as Le Théâtre and the general scientific journal La Nature. This analys results in two main findings: 1) medical journals used photography to assert their own disciplinary identities, and 2) photography acted as a potential bridge between audiences, as some medical and popular journals shared the same beliefs regarding photography's ability to represent the human body, but approached photographic innovations from different, albeit complementary, ways.

The genealogy of the clinical syndrome of mania: signs and symptoms described in psychiatric texts from 1880 to 1900

In 1800, mania was conceptualized as an agitated psychotic state. By 1900, it closely resembled its modern form. This paper reviews the descriptions of mania in Western psychiatry from 1880 to 1900, when Kraepelin was training and developing his concept of manic-depressive illness. Psychiatric textbooks published 1900-1960 described 22 characteristic manic symptoms/signs the presence of which were recorded in 25 psychiatric textbooks and three other key documents published 1880-1900. Descriptions of mania in these nineteenth century textbooks closely resembled those in the twentieth century, recording a mean (s.d.) of 15.9 (2.3) and 17.0 (2.3) of the characteristic symptoms, respectively (p = 0.12). The frequency with which individual symptoms were reported was substantially correlated in these two periods (r = +0.64). Mendel's 1881 monograph, Kraepelin's first description of mania in 1883 and the entry for mania in Tuke's Dictionary of Psychological Medicine (1892) described a mean (s.d.) of 19 (1.7) of these characteristic symptoms. These descriptions of mania often contained phenomenologically rich descriptions of euphoria, hyperactivity, grandiosity, flight of ideas, and poor judgment. They also emphasized several features not in DSM criteria including changes in character, moral standards and physical appearance, and increased sense of humor and sexual drive. Fifteen authors described key symptoms/signs of mania most reporting elevated mood, motoric hyperactivity and accelerated mental processes. By 1880, the syndrome of mania had been largely stabilized in its modern form. In the formation of his concept of manic-depressive illness, Kraepelin utilized the syndrome of mania as described in the psychiatric community in which he was trained.

Mental illness in Sweden (1896-1905) reflected through case records from a local general hospital

Mental illness in a hospital in a medium-sized town in Sweden was studied. Consecutive case records from 1896 to 1905, and also from 2011, were selected. In the historical sample, neurasthenia was the most common diagnosis, followed by affective disorders and alcohol abuse. ICD-10 diagnoses corresponded well with the historical diagnoses. Melancholia resembled modern criteria for depression. Mania, insania simplex and paranoia indicated more severe illness. Abuse was more common among men and hysteria among women. Those with a medical certificate for mental hospital care were very ill and showed no gender difference. There were no diagnoses for abuse, but 17% had a high level of alcohol consumption. The pattern of signs and symptoms displayed by patients does not appear to change with time.

Hospital Care for Jews in Nineteenth-century Amsterdam: The Emergence of the First Jewish Hospitals

In the early seventeenth century, the Jews formally established two separate communities in Amsterdam, the Portuguese Sephardi and the High German Ashkenazi congregations. Until the end of the eighteenth century, medical care for the Amsterdam indigent Jews had been controlled and regulated by the powerful Parnasim, the de facto rulers, of each community. The primary communal organizations that were exclusively responsible for medical care for the poor were the Bikur Holim societies. This approach for the care of the indigent Jewish sick became ineffective in the nineteenth century and was replaced by a hospital-based system. This essay describes how seriously ill indigent Jews in nineteenth-century Amsterdam received hospital care, tracing the establishment and development of the first Ashkenazi and Sephardi hospitals in the city. Although each community established their own hospital, they used different approaches to accomplish this goal.

Procedures and complications in late-nineteenth-century experimental neuroanatomical research exemplified by articles of Henry Herbert Donaldson (1857-1938)

Henry Herbert Donaldson (1857-1938) was a leader in neurological research in the United States for several decades, beginning about 1890. A detailed account of three of his earliest publications shows the neuroanatomical procedures involved in the study of the relation of brain and intelligence during the late-nineteenth-century in America. Two of the articles, published in September 1890 and December 1891, were titled, "Anatomical Observations on the Brain and Several Sense-Organs of the Blind Deaf-Mute, Laura Dewy Bridgman (1829-1889)"; the third, published in August 1892, used the information from the first two to delimit the extent of the visual processing area of the human cortex. Donaldson's procedures included brain cuttings and measures of macroscopic brain structures, histology of cellular structures, attempts to relate macroscopic brain structures with brain functions, data corrections, estimations, comparisons, and statistics. These procedures provide a view of the relative thoroughness, accuracy, and comparability of the various neuroanatomical techniques in use at that time and of Donaldson's implementation of the techniques. Donaldson's brain cutting techniques were much more comparable than his measurement techniques. The latter could be quite precise, but they were fraught with lack of standardized procedures that made corrections and estimations necessary when making data comparisons across studies. Donaldson emphasized these incompatibilities, implying a need for standardization. Statistical procedures were the least thorough and effective. His, and the field's, total complement of statistical techniques consisted of mean and range, which severely limited his ability to make complicated assessments. This limitation was not necessarily supplemented by stringent control group comparisons.

D.176: Sextants, numbers, and the Hydrographic Office of the Admiralty

In the 1830s and 1840s, the Hydrographic Office of the British Admiralty developed and oversaw one of the major state-run surveying projects of the nineteenth century. This involved a range of instruments whose circulation was increasingly regulated. Using extant museum collections and the correspondence of those involved, this article explores how such objects can be used to discuss both bureaucratic organization at a time of expanding government and the complex issues of sociability involved in hydrographic surveying. Surveying officers worked in a context in which the propriety of property on public service was a pervasive question. Instruments might be given as gifts between officers, appropriated as recompense, absorbed as state property, and disputed between friends. The ownership, provision, and treatment of instruments in particular could be used to demonstrate an officer's peculiar zeal or institutional neglect. To those outside the ship, what was understood as over-instrumentation became amusing spectacle. On board, their use was part of a deeply hierarchical order of work in regions of colonial and mercantile importance. In examining the relationships around these instruments of survey, the paper proposes a richer understanding of the material culture of hydrography in the early nineteenth century.

Antoine-Marie Chambeyron (1797-1851): a forgotten disciple of Jean-Etienne Esquirol (1772-1840)

Antoine-Marie Chambeyron (1797-1851) was a disciple of Jean-Etienne Esquirol (1772-1840) that history forgot, undoubtedly because he made no original contribution to psychiatric nosography. In 1827, his interest in the medical-legal status of the insane led him to translate into French and annotate the first medical-legal psychiatric treatise ever published, which was the work of the German philosopher Johann Christoph Hoffbauer (1766-1827). His translation played a role in shaping the French Law of 1838, the first piece of modern legislation aimed at protecting the rights of mental patients and limiting the State's power to confine them arbitrarily. Chambeyron is among the least-cited contributors to the prestigious work of nineteenth-century French alienists.

"His Native, Hot Country"1: Racial Science and Environment in Antebellum American Medical Thought

Relying on a close reading of more than 4,000 medicals student theses, this essay explores the evolving medical approaches to race and environment in the early national and antebellum United States and highlights the role that medical school pedagogy played in disseminating and elaborating racial theory. Specifically, it considers the influence of racial science on medical concepts of the relationship of bodies to climates. At their core, monogenesis-belief in a single, unified human race-and polygenesis-the belief that each race was created separately-were theories about the human body's connections to the natural world. As polygenesis became influential in Atlantic medical thought, physicians saw environmental treatments as a matter of matching bodies to their natural ecology. In the first decades of the nineteenth century, Atlantic physicians understood bodies and places as in constant states of flux. Through proper treatment, people and environments could suffer either degradation or improvement. Practitioners saw African Americans and whites as the same species with their differences being largely superficial and produced by climate. However, by the 1830s and 1840s medical students were learning that each race was inherently different and unalterable by time or temperature. In this paradigm, medical students articulated a vision of racial health rooted in organic relationships between bodies and climates.

Jan Evangelista Purkyně (1787-1869) and his instruments for microscopic research in the field of neuroscience

The findings obtained by the famous nineteenth-century Czech scientist Jan Evangelista Purkyně (1787-1869) in the field of microscopic structure of animal and human tissues, including the brain, spinal cord, and nerves, have already been described in depth in a number of older and newer publications. The present article contains an overview of the instruments and tools that Purkyně and his assistants used for microscopic research of tissue histology. Some of these instruments were developed either by Purkyně alone, such as the microtomic compressor, or together with his assistant Adolph Oschatz, such as the microtome. A brief overview of the development of the cutting engines suggests that the first microtome, a prototype of modern sliding microtomes, was designed and constructed under the supervision of Purkyně at the Institute of Physiology in Wrocław. Purkyně and his assistants, thus, not only obtained important findings of animal and human nervous and other tissues but also substantially contributed to the development of instruments and tools for their study, a fact often forgotten today.

American neurophysiology and two nineteenth-century American Physiological Societies

This article contrasts two American Physiological Societies, one founded near the beginning of the nineteenth century in 1837 and the other founded near its end in 1887. The contrast allows a perspective on how much budding neuroscience had developed during the nineteenth century in America. The contrast also emphasizes the complicated structure needed in both medicine and physiology to allow neurophysiology to flourish. The objectives of the American Physiological Society of 1887 were (and are) to promote physiological research and to codify physiology as a discipline. These would be accomplished by making physiology much more inclusive than traditionally accepted by raising research standards, by giving prestige to its members, by providing members a source of professional interchange, by protecting its members from antivivisectionists, and by promoting physiology as fundamental to medicine. The quantity of neuroscientific experiments by its members was striking. The main organizers of the society were Silas Weir Mitchell, John Call Dalton, Henry Pickering Bowditch, and Henry Newell Martin. The objective of the American Physiological Society of 1837 was to disperse knowledge of the "laws of life" and to promote human health and longevity. The primary organizers were William Andrus Alcott and Sylvester Graham with the encouragement of John Benson. Its technique was to use physiological information, not create it as was the case in 1887. Its object was to disseminate the word that healthy eating will improve the quality of life.

Vincenc Alexandr Bohdálek (1801-1883): Czech anatomist and neuroscientist of the nineteenth century

Vincenc Alexandr Bohdálek (Vincenz Alexander Bochdalek) was a well-known anatomist and pathologist in the nineteenth century. Today, however, his name is all but forgotten. Bohdálek described a number of anatomical structures; some of them became eponyms. Unfortunately, his findings concerning the innervation of the eye, upper jaw, hard palate, auditory system, and meninges are little known today. This current overview is based on available archival sources and provides an insight into his results in the field of nervous system research, which account for almost half his work. Bohdálek can clearly be considered a pioneer in the field we now call functional anatomy, as he tried to find a physiological explanation for the anatomical and pathological findings he observed. The work and results of this truly outstanding neuroscientist of his time are thus again available to current and future generations of neuroscientists and neuroanatomists.

'Noisy, restless and incoherent': puerperal insanity at Dundee Lunatic Asylum

Puerperal insanity has been described as a nineteenth-century diagnosis, entrenched in contemporary expectations of proper womanly behaviour. Drawing on detailed study of establishment registers and patient case notes, this paper examines the puerperal insanity diagnosis at Dundee Lunatic Asylum between 1820 and 1860. In particular, the study aims to consider whether the class or social status of the patients had a bearing on how their conditions were perceived and rationalized, and how far the puerperal insanity diagnosis, coloured by the values assigned to it by the medical officers, may have been reserved for some women and not for others. This examination of the diagnosis in a Scottish community, suggesting a contrast in the way that middle-class and working-class women were diagnosed at Dundee, engages with and expands on work on puerperal insanity elsewhere.

From One Medicine to Two: The Evolving Relationship between Human and Veterinary Medicine in England, 1791-1835

This article offers a novel perspective on the evolving identities and relationships of human medicine and veterinary medicine in England during the decades that followed the 1791 foundation of the London Veterinary College. Contrary to the impressions conveyed by both medical and veterinary historians, it reveals that veterinary medicine, as initially defined, taught and studied at the college, was not a domain apart from human medicine but rather was continuous with it. It then shows how this social, cultural, and epistemological continuity fractured over the period 1815 to 1835. Under the impetus of a movement for medical reform, veterinarians began to advance an alternative vision of their field as an autonomous, independent domain. They developed their own societies and journals and a uniquely veterinary epistemology that was rooted in the experiences of veterinary practice. In this way, "one medicine" became "two," and the professions began to assume their modern forms and relations.

The Place of Identity Dissonance and Emotional Motivations in Bio-Cultural Models of Religious Experience: A Report from the 19th Century

Durham University's 'Hearing the Voice' project involves a multi-disciplinary exploration of hallucinatory-type phenomena in an attempt to revaluate and reframe discussions of these experiences. As part of this project, contemporaneous religious experiences (supernatural voices and visions) in the United States from the first half of the nineteenth century have been analysed, shedding light on the value and applicability of contemporary bio-cultural models of religious experience for such historical cases. In particular, this essay outlines four historical cases, seeking to utilise and to refine four theoretical models, including anthropologist Tanya Luhrmann's 'absorption hypothesis', by returning to something like William James' concern with 'discordant personalities'. Ultimately, the paper argues that emphasis on the role of identity dissonance must not be omitted from the analytical tools applied to these nineteenth-century examples, and perhaps should be retained for any study of religious experience generally.

Discovering the structure of nerve tissue: Part 3: From Jan Evangelista Purkyně to Ludwig Mauthner

The previous works of Purkyně, Valentin, and Remak showed that the central and peripheral nervous systems contained not only nerve fibers but also cellular elements. The use of microscopes and new fixation techniques enabled them to accurately obtain data on the structure of nerve tissue and consequently in many European universities microscopes started to become widely used in histological and morphological studies. The present review summarizes important discoveries concerning the structure of neural tissue, mostly from vertebrates, during the period from 1838 to 1865. This review describes the discoveries of famous as well as less well-known scholars of the time, who contributed significantly to current understandings about the structure of neural tissue. The period is characterized by the first descriptions of different types of nerve cells and the first attempts of a cytoarchitectonic description of the spinal cord and brain. During the same time, the concept of a neuroglial tissue was introduced, first as a tissue for "gluing" nerve fibers, cells, and blood capillaries into one unit, but later some glial cells were described for the first time. Questions arose as to whether or not cells in ganglia and the central nervous system had the same morphological and functional properties, and whether nerve fibers and cell bodies were interconnected. Microscopic techniques started to be used for the examination of physiological as well as pathological nerve tissues. The overall state of knowledge was just a step away from the emergence of the concept of neurons and glial cells.

Insanity, belonging and citizenship: mentally ill people who went to and/or returned from Europe in the Late Ottoman Era

The Ottoman Empire, which encompassed a vast territory, had several facilities for the protection and treatment of the mentally ill. By the late nineteenth century, some wealthy families had begun to send their patients to mental hospitals in Europe for better treatment. During the same period, the process of repatriation of mental patients who were Ottoman subjects also began. These processes, which resulted in complex bureaucratic measures, later found a place in regulations and laws. The Ottoman Empire had an additional incentive to protect mentally-ill patients during the Second Constitutional Era, when discussions about 'citizenship' reappeared. This article examines the practices of sending mentally-ill people to Europe and the repatriation of mentally-ill Ottoman subjects from European countries.

The impact of water supply and sanitation on infant mortality: Individual-level evidence from Tartu, Estonia, 1897-1900

Evidence from a number of historical studies has demonstrated a strong impact of the provision of clean water on mortality risks, while no clear effect has been reported in others. We investigated the relationship between water supply, sanitation, and infant survival in Tartu, a university town in Estonia, 1897-1900. Based on data from parish registers, which were linked to the first census of the Russian Empire, the analysis reveals a clear disadvantage for infants in households using surface water, compared with families that acquired water from groundwater or artesian wells. The impact is stronger in the later stages of infancy. Competing-risk analysis shows that the effect is more pronounced for deaths caused by diseases of the digestive system. Our findings suggest that it may have been possible to improve the water supply, and consequently reduce infant mortality, before the introduction of piped water and sewage systems.

"The Glamour of Arabic Numbers": Pliny Earle's Challenge to Nineteenth-Century Psychiatry

A well-established interpretation associates the nineteenth-century psychiatrist Pliny Earle's deflation of high cure rates for insanity with the onset of a persistent malaise in patient treatment and public health policy during the Gilded Age. This essay comes not to praise Earle but to correct and clarify interpretations, however well intentioned, that are incomplete and inaccurate. Several points are made: the overwhelming influence of antebellum enthusiasm on astonishing therapeutic claims; the interrogation of high "recovery" rates begun decades before Earle's ultimate provocation; and, however disruptive, the heuristically essential contribution of Earle's challenge to furthering a meaningful model of mental disorder. In spite of the impression created by existing historiography, Earle, a principled Quaker, remained committed to "moral treatment."

The Dercum-Muybridge Collaboration and the Study of Pathologic Gaits Using Sequential Photography

In the late 1870s and 1880s, prior to the development of movie cameras or projectors, English-American photographer Eadweard Muybridge (1830-1904) photographed sequential images of people and animals in motion, using arrays of sequentially triggered single-image cameras. In 1885, Philadelphia neurologist Francis Dercum (1856-1931) collaborated with Muybridge at the University of Pennsylvania to photograph sequential images of patients with various neurological disorders involving abnormal movements, and particularly various gait disorders, including both the sensory ataxic gait of tabes dorsalis and various spastic gaits. Dercum used tracings of sequential photographic images to plot trajectories of limbs as a way to characterize and distinguish pathologic gaits. The Dercum-Muybridge collaboration produced the first motion-picture sequences of neurological gait disorders ever filmed. These sequences and the trajectory-based studies that derived from them were a milestone in studies of pathologic gaits.

Mastectomy with tears: breast cancer surgery in the early nineteenth century

BACKGROUND

By the early nineteenth century, breast cancer was better understood and surgical treatment was emerging as a more favoured option although anaesthesia had yet to be discovered. Many questions would have arisen for a woman advised to have surgery, including possible alternatives, what the operation would entail, pain and risks involved and the competence, ethical and professional behaviour of the surgeon. This paper addresses these questions in the context of the contemporary environment, focusing in particular on the personal experiences of the women involved.

METHODS

A review of the surviving personal letters and information regarding three women who had breast surgery, and of the contemporary surgical writings on breast cancer, training of surgeons, ethical and professional expectations and the concurrent status of women in society.

RESULTS

Surgical training was in its infancy and the first pronouncements on medical ethics had just been published. Pain, bleeding and infection presented formidable challenges and carried significant risks. Women were frequently devoid of information, suffered a loss of their dignity and were progressively stripped of their authority.

CONCLUSIONS

Breast cancer surgery was accompanied by enormous emotional and physical distress and significant risks from bleeding and infection. Although efforts were being made to give women a greater voice and autonomy in society, their position when receiving health care remained largely a submissive one. Lack of information, feelings of vulnerability, helplessness and loss of control occurred. The public perception of detachment most likely accounted for the occasional negative stigma then associated with the surgical profession.

Objectifying "Pain" in the Modern Neurosciences: A Historical Account of the Visualization Technologies Used in the Development of an "Algesiogenic Pathology", 1850 to 2000

Particularly with the fundamental works of the Leipzig school of experimental psychophysiology (between the 1850s and 1880s), the modern neurosciences witnessed an increasing interest in attempts to objectify "pain" as a bodily signal and physiological value. This development has led to refined psychological test repertoires and new clinical measurement techniques, which became progressively paired with imaging approaches and sophisticated theories about neuropathological pain etiology. With the advent of electroencephalography since the middle of the 20th century, and through the use of brain stimulation technologies and modern neuroimaging, the chosen scientific route towards an ever more refined "objectification" of pain phenomena took firm root in Western medicine. This article provides a broad overview of landmark events and key imaging technologies, which represent the long developmental path of a field that could be called "algesiogenic pathology."

Melancholia before the twentieth century: fear and sorrow or partial insanity?

Throughout the history of psychopathology, several meanings have been assigned to the term melancholia. The main ones were related to affective disorders (fear and sadness) and abnormal beliefs. At the time of Hippocrates melancholia was regarded mainly in its affective component. Since that time, and until the eighteenth century, authors and opinions have been divided, with both aspects (affective disorders and abnormal beliefs), being valued. Finally, in the eighteenth to nineteenth centuries, with Pinel at its peak, melancholia becomes exclusively a synonym of abnormal beliefs. At the turn of the nineteenth to the twentieth century, the affective component returns as the main aspect characterizing melancholia.

A contextual analysis of nervous force in medico-scientific and literary writings in English of the nineteenth and early-twentieth centuries

This study concerns the context of use of the term "nervous force," as it appears in scientific and literary publications in English over the course of the nineteenth century and the first two decades of the twentieth century. The context of use, loss, or waste of nervous force and the context of nervous force as an expression of an attribute are analyzed in 189 scientific and 105 literary writings. Both contexts appeared in literary writings, where nervous force expresses the attributes of strength, forcefulness, vigor, or energy and use, loss or waste of nervous force explains such nonmorbid conditions as why someone is tired or needs rest. Only the context of use-loss-waste appeared in the medico-scientific literature, but here it explained both nonmorbid conditions (for example, effects of old age) and morbid conditions (like epilepsy). Changes in the number of these references give insights into the medico-scientific and the literary disciplines. Discussions include why nervous force is associated with explanation of disease, the persistence of its use in this capacity, and its influence on a similar use in literary writings.

The effect of anti-abortion legislation on nineteenth century fertility

Using nineteenth century legal information combined with census information, I examine the effect of state laws that restricted American women's access to abortion on the ratio of children to women. I estimate an increase in the birthrate of 4 % to 12 % when abortion is restricted. In the absence of anti-abortion laws, fertility would have been 5 % to 12 % lower in the early twentieth century.