Preprint Articles

In 1920, maternal mortality rates in the United States exceeded those of other industrialized nations. To redress this statistic, the federal Children’s Bureau set its sights on improving access to prenatal care at a time when 80 percent of American women received none. In 1921, following lobbying by urban, middle-class progressive women working at or in support of the Bureau, the government legislated for prenatal care programs through the Sheppard-Towner Act. To date, historians have focused on how successfully women implemented the act’s provisions, paying less attention to whether support for rural mothers reduced maternal mortality rates. Using Children’s Bureau pamphlets, documents pertaining to the Sheppard-Towner Act, and letters written to the Bureau from poor, rural women, this article brings government workers, medical professionals, and the women they served into dialogue to analyze the first push to establish prenatal care for underserved American women and the obstacles that stood in the way.

Phlegm figures as a major cause and consequence of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of phlegm is entirely absent. The rise of phlegm is one of the fundamental transformations in the history of Chinese medicine. This article suggests that the little-known Yuan dynasty treatise On the Art of Nourishing Life (1338), which is notable for extending Chinese phlegm theory in unprecedented ways, was pivotal for this transformation. Noting a strong resemblance of the innovations of this treatise with Galenic medical theories, this article argues that they were inspired by an encounter with the Galenic medical tradition. It submits that these innovations radically altered pre-existing Chinese understandings of the body’s materiality and the nature of disease. And it calls for closer attention to the transcultural movements of theories and concepts in the historiography of Chinese and global medicine.

This article explores a poorly understood smallpox vaccination campaign targeting Native Americans in the 1830s. While previous scholars have addressed the motivations of U.S. officials in launching the campaign, the author focuses on Indigenous people’s interest in disease prevention and their reception of American physicians and vaccine technology across a broad swath of North America. Resistance to vaccination was not uncommon among Native people, yet many were open to the new form of preventive medicine, including some who sought it out and others who demanded it from the government. Departing from a scholarly consensus, the author argues, first, that the federal vaccination program should be viewed as a successful public health intervention in Indian Country and, second, that this success owed to Indigenous nations’ desire for protection against a singularly destructive pathogen.

The emergence of obstetric anesthesia in the second half of the nineteenth century was preceded by a transformation in the medical conceptualization of women’s pain. In the eighteenth and early nineteenth centuries, physicians described pain in physiological terms as natural and unproblematic, but in the second half of the nineteenth century they adopted a newly emotional language that emphasized women’s subjective experiences of suffering. Middle-class and elite white women shaped this transition by insisting that their physical and emotional anguish was extreme. Women’s attitudes, combined with a growing perception that sensibility to pain was a marker of “civilization,” pushed physicians to view suffering as real and problematic. As they began to depict pain relief as an urgent medical concern, physicians envisioned refined white women as the primary beneficiaries of their new technology; this perspective paved the way for the increasingly routine use of anesthesia for middle-class and elite white women.

Psychiatric epidemiology has significantly influenced public health policies all around the world. This article discusses how Finnish epidemiologists reacted to local needs, which were born in specific circumstances and were controlled by science policy and funding opportunities. The development between the 1900s and 1990s is divided into three stages. The first Finnish studies in the field focused on the prevalence of mental illnesses in the country. The focus was to gain information for service planning, most of all to estimate the need for new hospitals and to set up the national social insurance system. After the Second World War, structural changes and social engineering fueled epidemiological interest. From the 1960s until the late 1980s, psychiatric epidemiology was interconnected with social psychiatry, which held a strong position in Finland. Since the 1990s, Finnish psychiatric epidemiology has been integrated with international epidemiology by using shared methodologies and through participation in transnational studies.