Category Archives: Science

Review: Encyclopedia of asylum therapeutics, 1750/1950s”

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Encyclopedia of asylum therapeutics, 1750/1950s

I have been fascinated with medical history for nearly a decade now so when I saw a chance to review Mary de Young’s book “Encyclopedia of asylum therapeutics, 1750/1950s” I jumped at it. By the time it arrived I was having second thoughts, I have not read anything about the history of psychiatry, the book is an imposing 353 pages of double column text, and I had just struggled through a book that failed to catch my interest at least in part because I felt it lacked organization. This book was obviously organized, as an encyclopedia. I was concerned about its readability, how many encyclopedias compel you to keep reading? This one.

I should have expected that the early treatment for various real and imagined mental disorders would have been based on the same Greek theories of humoral balance as physical medicine was up until the middle of the 19th century. Even the same players were showing up, Dr. Benjamin Rush, a founding father, medical advisor to the Lewis and Clark expedition, and professor of medicine at the College of Philadelphia Department of Medicine turns up in more than a few entries. Benjamin Franklin came up with an electricity based treatment and, when it seemed to work, he wrote that it could have been her faith in the treatment that cured her, not the treatment. This was decades before the term “placebo effect” was even coined. So many of the “treatments” documented here by de Young were also used to treat physical illnesses and she explains them so clearly that this book is a valuable resource for any student of medical history.

If you have ever questioned why so many horror movies are set in asylums this book holds the answer. Bethlem Asylum, also known as Bedlam, and its treatment regimens are frequently discussed and they, and the rational for them, are fascinating. If someone is manic, they need a calming influence, try music, try putting them in a pink room*, try bleeding them, try bathing them in static electricity.** If they are sullen, refuse to interact with the world, raise their spirits, try music, try a green room, try bleeding, try a cat piano, a cat piano is a box containing a number of trapped cats and is equipped with a keyboard that cause a nail studded hammer to hit a cat’s tail. It is believed to be imaginary but imagine the cacophony it would create. I can imagine it would wake the dead as well as get the attention of any mental patient.

In another book that I read recently it was pointed out that in the late 1800s there was a movement painting masturbation as both evil and very dangerous. I noticed in this book a change in the language, before the late 1800s it was very possible to be institutionalized for “excessive masturbation” but then the explanation of a patient’s madness became simply “masterbation”. The extreme range of treatments for any madness that the doctors associated with sex was frightening. “Wiring”, surgical implantation of a wire into the end head of a man’s penis to stop, well, you know what it was intended to stop. This was about the same time that male babies in the US began to be circumcised, not to “prevent disease” but in an attempt to make masterbation less appealing.

More modern treatment are covered, transorbital lobotomy is accompanied by a photograph I found a little disturbing outside of a zombie movie. There is also enlightenment for social commentators on current causes. Ritual clitorectomeys are desturbing in other cultures but before we demonize them maybe we need to understand the use of the procedure, and other sexual surgeries, in our history.

The writing is clear, as clear as the topic permits anyway, and very well documented. The citations are at the end of each section, a system I find much easier to use than crowding all of them in the back of the book. As much as I enjoyed the book it is a very specialized topic. I doubt it will become a bestseller but if you are interested in medical history this book is indispensable.

* As I write this, belittling chromotherapy, the color cure, I see this article about current experiments with using colored light as a treatment. https://clinicaltrials.gov/ct2/show/NCT01782378

** I have to wonder it the ozone produced by the static electricity might have had some effect on the patient, possibly a mild euphoria from the oxygen boost?.

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Review: Unfair the new science of criminal injustice

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Unfair: the new science of criminal justice

Several years ago I took a class on social psychology and, after learning about some “classic” experiments and the damage done to the participants I wrote the field off as, well, evil. Adam Benforado forced me to rethink that with his constructive use of that science in supporting the arguments in his book “Unfair: the new science of criminal injustice”. Benforado is a law professor, after reading his book I have to imagine he is a good one. He is an insider and I expected him to be more supportive of the current state of the American criminal justice system than I am but, no, it seems that the view on the inside is even worse than it is from the outside.

Benforado divides the book into four parts. Investigation, where he looks at the victim, police, and the suspect. Adjudication examining lawyers, the jury, the eyewitness, the expert witness, and the judge. Punishment, both popular views and the real effects on prisoners. He explains what our system gets wrong and provides evidence to support his claims. In the final part, Reform, he discusses possible solutions to those problems.

Personally I am proud to call myself a bleeding heart liberal. I think that admission should lend a little credibility when I say that Benforado in not a liberal, bleeding heart or otherwise. Some of his major concerns are not wasting taxpayer money, convicting the right person and administering just punishment. I agreed with almost everything he said even some solutions that I believe to be beyond our current capability. Change the focus of our criminal justice system from punishment to rehabilitation? Not going to happen.

Blame and punishment is to deeply imbedded in our Judeo-Christian culture. When discussing blame Benforado said “When a dangerous virus overwhelms a town, causation is relevant, but blame isn’t. We don’t treat someone who has contracted Ebola or dengue fever as sinful. We get to work restoring the person’s health, preventing new cases, and trying to eliminate the root cause.” I am not so sure I can agree with that. I am old enough to remember when AIDS first made the news. It took an innocent child, someone who contracted the disease through a blood transfusion, to slow done the blame the victim attitude. “Christian” preachers can’t resist the chance to label a disease as “God’s revenge” for sinfulness. We even blame the victims of natural disasters for causing the destruction through their sinfulness.

I have to recommend this book to everyone. If you live in the US it will help you understand how and why our criminal justice system is failing and if you live in Europe you can see what your systems are doing right. I expect to hear about this book quite a bit over the next year as Benforado’s suggestions are debated in the media.

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Book Review: The Cholera Years: the United States in 1832, 1849, and 1866

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The Cholera Years

“The Cholera Years: the United States in 1832, 1849, and 1866” is only tangentially a medical history. Charles Rosenberg used the opening year of the three worst epidemics of cholera in the United States as lenses through which he could take snapshots of American society. In each year examined the disease spread westward across Europe to inevitably reach the shores North America. By looking at how the medical and religious communities, public officials, and the people, those represented by newspaper editorials, reacted to the stress of the impending epidemics Rosenberg was able to clearly show how society changed over the decades.

“The nest of college-birds are three
Law, Physic, and Divinity
And while these three remain combined
They keep the world oppressed and blind.
On Lab’rers money lawyers feast
Also the Doctor and the Priest.”

This poem, from 1832, shows that popular American distrust for academics is long held. However by 1848 even the upper-class was turning its back on physicians. Today we see governors who ignore the best scientific opinions and follow their own ignorance on Ebola. It does seem that the more things change the more they stay the same. Rosenberg attributes this to the medical communities inability to cope with epidemics, the 1832 outbreak of cholera in particular. The fact is that Galenic physician’s had never been effective. What was it that changed between 1832 and 1848 that made their ineffectiveness unacceptable? Rosenberg does not really look at what caused the change, he just shows that the general attitude did change.

Originally published in 1962 Rosenberg’s book is still readable. The writing is better, in my opinion, than most of the histories published today. I recommend it to anyone interested in 19th century American history, it provides insight to the social values of the times. I do wish that someone would take a look at what caused attitudes about physicians to change. Was it competition? Thomsonians, herbalists, and Homeopathic medicine was giving the traditional physicians competition. They were saving more people by avoiding, at least in large doses, the mercury, arsenic, and other poisons that were some of traditional physicians favorite medicines. I have read how physicians reacted to the competition. One way strategy was forming a trade union, the American Medical Association, and blackballing Homeopaths. I would like to see a scholarly paper on how people reacted to the competition.

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Book Review: Cholera The Biography

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Cholera : The Biography

History is much more than naming Kings, Presidents, and Generals. In “Cholera : The Biography” Christopher Hamlin looks at the ‘life’ of the disease that came to be known as Cholera and along the way manages to show us the development of medical science over the last two hundred years. Before Cholera there was cholera, western medicines name for the “stomach flu”, a 24 hour bout of diarrhea. In 1817 British physicians serving in colonial India noticed a new cholera. It came on with a feeling of unease then came violent vomiting and diarrhea, muscle cramps, the patient’s skin became bluish and their heartbeat unsteady and, in most cases, they died, all with within a single day.

Western medicine, essentially the same medicine practiced by Hippocrates and Galen in ancient Greece, saw disease as the imbalance of the bodies “humors” brought on by foul odors, a change in the air, or sin. Vomiting and diarrhea were good things, the body trying to restore balance. Cholera in India was obviously a result of “filth”, a catchall term for “not like us”. As cholera came closer to Paris and London, it became clear, to the physicians of Paris and London, that the cause was less “filth” and more the judgement of God.

Hamlin covers the changing attitudes toward cholera, the evolving and devolving of cholera treatment by physicians as they groped for treatments and causes and fought to maintain their status and egos. He also looks at the range of government responses to the epidemics, dancing between protecting population and protecting trade.

Cholera was the subject of what was possibly the first “disease biography”, Norman Longmate’s “King Cholera : The Biography of a Disease”, in 1966 and has been featured in other medical histories since then. I now understand why. It spans, and may have helped initiate, the scientific revolution in medical science. At the time Longmate wrote his work Cholera was seen as defeated. We had treatments, we knew the cause of it, we had preventive measures that worked. However the physicians of 1817 also knew that disease was brought on by foul odors, a change in the air, or, possibly, sin. Advances in medical science since the 1960s have changed our medical understanding as much as it changed between 1817 and 1960.

Hamlin’s writing is often fun to read, as when he is explaining how the authorities believed that since “a feeling of unease” was the first symptom reported they believed that a “feeling of unease” may be the cause of cholera. “Worry about fear (or fear of worry) was often at the heart of these {governments}efforts. You might make hysteria a crime, as McGrew notes of Russia, but any attempt to stop it would cause it.” A little science background helps but is not really necessary. At times having a strong stomach helps, there is much discussion of fecal-oral transmission and, obviously, diarrhea.

I learned quite a bit about the advancement of science in the 19th and 20th centuries from this book. Even better I came to understand the present day better after Hamlin compared the debate over the causes of cholera to the climate change debate. Neither side is likely to be convinced until the other essentially proves a negative. “Cholera : The Biography” is perhaps the most enlightening history I have read in the last year and with Ebola in the news seeing how difficult it is to quarantine a disease and how economics and ego can put ahead of public health is cause for concern.

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My 100 Proof Hobby

I seem to have developed a new “hobby” over the last year or so. I was with my wife at one of the conferences at the JW Marriott in Washington DC in the winter of 2013. We had just flown in, tired and hungry we went to the hotel restaurant for dinner. Of course the first thing they give us was a drink menu. On the menu they claimed to be the hotel that served the first Gin Rickey over a century ago. I had recently read a book, “America Walks into a Bar”, and in it I learned something about how “cocktail culture” developed. Their claim sounded reasonable so I ordered one.

This shocked my wife. We joke about being a mixed marriage, she drinks wine and I drink beer. When I say I drink beer let me clarify, a six pack can last me a month. And I have had cocktails before. Dad made Mai-Tais for us kids on the holidays and mom’s “cold medicine” is better known as a Hot Toddy, but that was the first cocktail my wife ever saw me order. She still should not have been shocked. I bought a bottle of cognac when we got married and occasionally drank a shot of it. That bottle lasted almost a decade so the key word here is “occasionally”. We also, at times, had vodka and bourbon in the house. My wife made a killer Cranberry Vodka Pork Chop and her Bourbon Sweet Potato Pie is the best anywhere. I occasionally had a shot of the bourbon or made someone a Hot Toddy when they were sick but no one would have said we were into cocktails. Good liquor, I said, should be enjoyed straight.

That Gin Rickey was great. Even my wife agreed. So when we got home I went and got a bottle of gin, a bottle of lime juice, and one of club soda and I mastered the Gin Rickey. The same conference this year was in San Diego. My wife had lived there when she was fresh out of high school and she took me around town to see the sights. We had a late lunch in Old Town and the waiter asked if I would like some Tequila. At first I said no, but I had second thoughts about that. We had ridden the train and walked to get there. One shot was not going to be a problem and after all, where else could I expect to get good Tequila? So I told him to bring me a shot. When he asked what brand I confessed to him that I had never tried it before and asked him to pick something good. I wish I had paid attention to what brand he picked, it was good. (He stood there and watched me take the first sip, I think he was expecting a reaction from a “non-drinker”. If that was the case he went away disappointed. I may never have had tequila but I grew up in the land of bourbon.) The next day at a restaurant near the museums in Balboa Park I decided to try something else new to me, a martini. It was nasty, all sugary sweet, no bite, and, no taste except sweet. When we got home I started thinking about how bad that martini was. Would James Bond drink something like that? Not a chance.

I remembered that, in our collection of cookbooks, we had two about cocktails. A 1984 printing of Mr. Boston’s Guide and a 1934 book titled “Charles’ Book of Punches and Cocktails”.  There are also a lot, a lot, of free and low cost apps about mixing cocktails that I found when I started looking there. So I started looking, reading the little recipes, some sounded horrible, some sounded interesting. I decided to have the kids, and their kids, over for a Labor Day party where I would let them try some of the different concoctions. Even the teenage and younger grand-kids got into the act with Shirley Temples, Arnold Palmers, and Roy Rogers, all non-alcoholic drinks. I think we all had a good time and I am planning a Halloween get to get together with drinks with names like Zombies.

Now that I am paying attention I notice that I am not the only one looking into the cocktail culture. In August I learned that I was to review “Of All the Gin Joints : Stumbling through Hollywood History” and  recently I heard the author of “The Curious Bartender: The Artistry and Alchemy of Creating the Perfect Cocktail” interviewed on NPR. I have seen articles on “shandys”, drinks for when beer is too heavy, for example, one part lager beer and one part fruit juice. Another one on making your own bitters was more surprising. There is even a book devoted to bitters, “Bitters: A Spirited History of a Classic Cure-all”. I have not even gotten far enough into mixology to use bitters. These days, around 8:00 in the evening you can find me mixing a cocktail, one I have never tried or a “revised” recipe of one that did not seem as good as it should be.

Bond was right, martinis can be very good when done right. Trying these recipes can be a bit of an adventure. In the older books measurements are vague or even optional. Thankfully with Google I have a hope of learning how much a “pony” or a “wine glass” is supposed to be. (1 ounce and 4 ounces) Unfortunately dashes and splashes are still just as vague as they were 80 years ago. Some of the drinks I have tried I should have known better, a White Plush, equal parts whiskey and milk, is not going to be a modern hit. Some are much better than their names suggest, an Ambassador or a Cincinnati Cocktail for instance. If you are feeling thirsty you might try my newest favorite, an Incider. One part Bourbon with six parts Apple Cider. Just pour the whiskey over ice in a rocks glass and top off with the cider. When I offered my wife a sip of my first attempt at this cocktail I never got the glass back.

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Review: Missing Microbes

Helicobacter pylori from WiliMedia Commons

Helicobacter pylori from WiliMedia Commons

Every now and then when I finish a book I have to sit back and take a long breath and reflect. Martin J. Blaser’s Missing microbes : how the overuse of antibiotics is fueling our modern plagues is one of those books. I requested it from LibraryThing.com’s Early Reviewer program as soon as I saw it offered. For the last few years I have been studying the last 200+ years in medical history. Germ theory has existed for only a little more than half of that time. I was interested in what Dr. Blaser considered missing microbes. I had also heard a story on NPR a few months ago that stuck in my head because of its ingenuity and grossness. Some people with severe digestive disorders have been treated with a , uh, well they have the gut bacteria from a healthy donor transported into their gut. It works, their symptoms clear up.

Blaser points out that all life started out microbial and slowly formed colonies that specialized into multicellular life, into more and more complex forms of life and that all that time the multicellular life co-existed with single cell life forms. Some of them are dangerous. If Vibrio cholerae takes up residence in your gut it produces a chemical that mimics one your body naturally uses to signal the intestinal walls to move water out of the body. Cholera caused such severe diarrhea, moving water out of the body into the gut, that it could kill a health person in less than a day. Luckily most of the microbes in and on our bodies are harmless or even helpful. At least one digests food we are unable to use into forms that we can use. How many microbes are there that provide us with benefits that we don’t know about?

The star of the book is Helicobacter pylori, a spiral shaped bacteria first discovered in the early days of germ theory and quickly forgotten about. It was found in everyone’s stomach and it was impossible to grow in the lab with the existing technology. Many years later it was rediscovered in the stomachs of some people and it was blamed for very bad things ranging from ulcers to stomach cancer. How did it go from being in everyone’s stomach in the late 19th century to only some stomachs in the mid to late 20th century? Wide spectrum antibiotics.

The book makes a very good case for the theory that our overuse of antibiotics, over prescribing and using in animal feed, is not only creating Multi Drug Resistant, MRD, bugs but it is killing off potentially helpful bacteria that has co-existed with human beings for ages. After demonstrating a correlation between acid reflux disease, which can progress into nasty throat cancer, and the lack of H. pylori Blaser asks if the modern rise in allergies, asthma, autism, obesity,* and type 1 diabetes are the result of a missing beneficial bacteria.
In my opinion in a hundred years this book will be considered a major turning point in medical science. I don’t know how the medical establishment will look at it today. There is so much money wrapped up in the status quo that any change, even for the better, will be resisted. I have never been a fan of hand sanitizer and after reading this I will question my doctor about the necessity of any antibiotics he offers me. You need to read this book.

* low dose antibiotics have been given to farm animals for over 50 years to speed their growth, antibiotics are undoubtedly one factor in the obesity problem.

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Review: Summer for the Gods

Clarence Darrow and William Jennings Bryan, 1925When I started reading “Summer for the gods: the Scopes trial and America’s continuing debate over science and religion” I thought that I knew something about the Scopes trial. As the author points out, most Americans feel that way. Edward J Larson, the author, is a professor at Pepperdine University. He has both a PhD in history and a law degree which should make him very qualified to write this book. For me the most important part of of the book was the “before” and “after” sections, the actual events of the trial turn out to be less surprising, and less important, than why it happened and what the results were.

The events prior to the trial was most surprising to me. Religious fundamentalists writing for social justice? That surprised me even considering that the society they wanted justice for was lily white and strictly Christian. Evolution was, by the 1920s, a settled issue with most churches. The modern leaning churches accepting science and the pentecostal churches, those that came into being during the First Great Awakening when Europeans and Africans worshiped together as bondsmen to the wealthy English planters, rejecting science as an evil influence that would destroy morality. Outlawing the teaching of evolution was a dead idea until William Jennings Bryan began to advocate for it. As an experienced politician he was quickly successful in attracting conservative fundamentalists to the cause.

The trial was instigated by the American Civil Liberties Union in an attempt to protect teachers freedom of speech and freedom from government sponsored religious influence in the classroom. Unfortunately they soon lost control of the trial when Bryan and Clarence Darrow, two of the era’s biggest headline makers, were recruited to argue the case. The prosecution and the ACLU wanted to focus on the law itself, Bryan and Darrow both wanted religion introduced into their arguments. As we all know Bryan and Darrow prevailed.
Scopes was convicted, giving the ACLU a chance to appeal to the state supreme court. This was partially botched by a local attorney who had latched on to the trial as a chance redeem his reputation. Since the appeal was on a very limited point the ACLU expected to lose in Tennessee State Supreme Court and was planning strategy for an appeal to the US Supreme Court when Tennessee pulled the rug out from under them by overturning the conviction on a point they had not been asked to look at. With no conviction there was nothing to appeal effectively ending the legal battle.

After the trial both sides felt they had won. The anti-evolution forces managed to get laws passed in more states, southern and western states but failed in the north and midwest. The ACLU was unable to recruit any teachers to serve as another test case. But when the anti-evolution forces stopped trying to pass laws outside their areas it appeared to many that the fundamentalists had accepted defeat. As we know from current events they only turned inward to regroup. Bryan’s legacy suffered from his association with the trial. To his liberal friends it appeared that he had suffered from bad judgement in his later years and deserted them. To the anti-evolutionists he went from a hero leading their cause to a traitor for his testimony that perhaps Genesis described eras not 24 hour days.

Larson is a good writer, he is intelligent enough to dispense with polysyllabic words meant to impress rather than inform and he did the work to explain the era that colored the trial and how the trial colored the era that followed. His book provides a window to help us understand current events.

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