The Last Resort

Vladimir Jankovic, “The Last Resort: A British Perspective on the Medical South, 1815-1870,” Journal of Intercultural Studies 27, no. 3 (2006): 271-298.

In this piece on British health travel to the Mediterranean, Jankovic aims to focus on the “…ways in which the medical reasoning and disease etiology impinged on the choice of resorts and regimens, and how such choice meshed with the broad understanding of the region based not only on the geographical and medical documents but also on its changing cultural stereotypes.” (272) He argues that medical opinion explained some aspects of health travel, but not all, as evidenced by the rapidly changing resort hotspots. Though Jankovic asserts that the “career of British climatotherapy… often drew upon the lay rather than scientific consensus and… often passed it verdicts in accordance to the Victorian environmental mores rather than observations, mortality tables or climatological statistics…,” he acknowledges the vital role that the “garb of impartiality and… use of scientific jargon…” played in legitimizing and differentiating different resorts. (272-73)

Explains how temperature was understood to be a determinant of environment-specific physiologies and moralities (environmental determinism) (275)

Some physicians (?) (Sir James Clark) were calling for a more “scientific” approach to health traveling, insisting that “the migration South ought to be based on the knowledge of climatic specificity and the taxonomy of resorts based on morbidity statistics,” but this taxonomy was only beginning to emerge in the 1830s. The prerogative to travel and choice of destination were considered primarily in the context of social factors; “fashion and custom ruled.” (276)

Jankovic touches on the “diseases of civilization,” which, alongside chronic physical illnesses like TB, skin diseases, kidney and liver issues, and cancer, afflicted many health travelers.

Similar to the book on health-seeking in the West by the guy from OU, this article touches on health travel as impetus for territorial/colonial expansion (277)

Science and statistics coming into resort therapy: “From the mid-nineteenth century…[n]ew medical researchers began to seek the attention of the public and the profession by using whatever (quantitative) observations they could put their hands on to dissect climatological hearsay which, in their view, had spurred a facile and unjustified veneration of Southern Europe among the deluded expatriates.” (281)
Use of data to find “truth” in accounts of therapeutic efficacy — attempt to base traveling for health on a scientific epistemology.
“For this emerging group of climatotherapeutic statisticians only a careful attention to meteorological conditions might dispel (or confirm) popular perception and determine which, if any, of the environmental factors could be identified as curative in landscapes of brighter sun, drier air, and warmer breeze.”

Anti-resort therapy science: Discussion of the counter-narrative (exemplified by the work of John Charles Atkinson and Thomas Burgess), which held climatotherapy to be a fad; Atkinson believed that “fresh air” didn’t help cure people and that traveling was dangerous. People were better suited to the climates from whence they came, and modifications in temperature exposure could be conducted in the home by wearing more or less clothes and using heaters, respirators, etc. “Such arguments made understandable the fact that eudiometry (the sciences of measuring the ‘virtue’ of pure air) and chemical analyses failed to discriminate…” between air/water from resorts and from inner cities. Both men used statistics to bolster their arguments against the effectiveness of warm climates on mostly TB. (283-285)

Jankovic uses a controversy over the salubrity of Madeira’s climate to delve into the role of science in determining health benefits/disadvantages. James Mackenzie Bloxam, who traveled to Madeira for health reasons yearly, wrote out against the scientists defaming the resort. “The thrust of Bloxam’s argument was to challenge the validity of scientific methods in identifying the influence of climate on disease, especially when independent means existed by which these influences could be demonstrated… [d]ata might be fictions made up by badly calibrated instruments, and read by people without qualification and experience.” Bloxam was bothered by the total reliance on “meteorological journals and quantitative science,” believing that it should be accompanied by “a clinical picture or patients’ own reports.” “Why use science…[when] common knowledge and personal feeling would suffice? Why call upon meteorologists when patients might be more qualified to pass the climatological verdict?” “Bloxam appealed to tradition and common sense. He thought that the practice of medical travel was sufficiently established to tolerate an ‘expert’ intervention from the outsiders like Burgess.” (288-289)
This is the same sentiment I see in early ads for ES. When science fails to explain therapeutic effects that have been witnessed, the inclination of those who have witnessed it (or just want to believe?) is to question the authority of science in the realm of therapeutics. Is not the patient’s experience a more important component to understanding therapeutic efficacy? Why bring in a scientist to determine the answer to a question that’s already been determined in a much more immediate, real way?

In the end, science (statistics) wins the battle. It gains authority in the field of climatotherapeutics. Despite these misgivings about scientific intrusion, Madeira was obsolete two decades later. Doctors quit sending their patients there. Mounting evidence of the resort’s failure to cure, and even exacerbation of, TB, lent credence to “the quantitative approach to… Mediterranean climatotherapy,” and its propensity to influence “…the medical profession’s judgement on the value of health travel…” “Scientific writers presented their case as a long-overdue audit of a complacent medical opinion that concealed professional idiosyncrasy, anecdotal evidence, and social prejudice. Climatologists staged a putsch using the weapon of impartiality.”


Modern Airs, Waters, Places

The Bulletin of the History of Medicine put out a special issue in the winter of 2012 that focused on the resilience and evolution of the “airs, waters, places tradition.” (It was edited by Alison Bashford and Sarah Tracey — the latter is on my MA committee!!!)

Though the contributors are for the most part concerned with the 20th century, the introduction to the issue contains some historiographical information about studies on climate that are incredibly helpful for getting my feet wet.

First off, it looks like historians studying climatology have been arguing for some time that the traditional signposts of modern medicine — germ theory and bacteriology — did not alter the way that laypeople, physicians, or scientists understood wellness and disease. Rather, “…microorganisms continued to be understood in relation to an environmentally shaped human physiology…[and]…[m]edical men continued to gather and assess meteorological data in minute detail long after microorganisms were known to be necessary and sufficient to cause disease.” (504)

The introduction also observes the domination of tropical medicine and its links to colonialism and race over the scholarship on medical climatology. Tracy and Bashford admit that this is important and extensive work and that it has provided us with a firm basis of understanding when it comes to “…environmental determinism, and the specific science and politics to which it was put, especially over the colonial 19th and early 20th century..” The authors encourage us, however, to look “beyond the link between tropical medicine and colonialism, beyond temperate versus tropical, and beyond latitude to think of altitude.” (497)

There seems to be a much smaller bit of literature on the domestic/local manifestations of the “airs, waters, places tradition,” and what exists seems to be focused on the early modern period. (503) “One interpretive ambition in this context has been less to identify racial, imperial, or even national politics of human difference, and more to understand the logic and fortunes of ‘holism’ in the comprehension of disease and the pursuit of health.” (503)

Inventing Caribbean Climates

Mark Carey, “Inventing Caribbean Climates: How Science, Medicine and Tourism Changed Tropical Weather from Deadly to Healthy,” Osiris 26, no. 1 (2011): 129-141.

In this piece, Carey traces changing European and North American perceptions of Caribbean climates from 1750-1950. He argues that these understandings were not shaped only by the climactic science; rather, they were constructed around multiple considerations, including “…environmental conditions, knowledge systems, social relations, politics, and economics.” (129) Carey understands these ideas, then, to be culturally constructed and argues, in line with most recent studies on climate, for the cultural construction of climate.

“Climate constructions…changed over time and were dependent upon where observers went, why they went there, which geographical features they saw, who they encountered, how landscapes looked to them, and what scientific knowledge they had.” (131)

Goes through perceived salubrity of mountains and wind (133-34); no professional medical perspectives represented, though. Links belief in windy, mountainous areas to lingering miasmatic understandings of disease.

“For many, these winds had the potential to purify the spirit, rejuvenate the body, and prevent illness — as if the wind blew away diseases before they could infect a person.” (134)

Discussion of the social situation of an area being linked to understanding its climate; post-revolution Haiti was less healthy, ruled as it was by former slaves. (135)

Proximity to urban spaces also factored in; “Such preferences for the climate of rural, less crowded areas corresponded with nineteenth-century romanticism, which tended to privilege pastoral, rural, and even sublime landscapers over those of increasingly industrialized and polluted areas.” (135)
I feel like ES was trying to appeal to this class of customer; disillusioned/bothered by St. Louis and its health issues, rural ES was a healthful escape.

George Washington travelled to Barbados for health reasons! Cool.

“Dr. William Hillary… wrote on the effects of rainfall and temperature on diseases, explicitly following the theories of Hippocrates and referring to the ancient thinker as ‘that wise father and prince of physicians.'” (136)
Decided link to Hippocratic medicine in study of climate & disease by a laaate 18th century physician. 

Highlights role that germ theory and mosquitos as vectors had on de-pathologizing tropical climates. When were mosquitos identified as vectors for malaria?

“Breezes, mountains, trees, and temperature were the main criteria used to define salubrious versus unhealthy climates.” (141)


Purity and Danger


Douglas claims that the book is “a late blow struck in the battle which anthropology in the 1940s and 1950s was fighting against racism.” What characterized this “battle,” and was it within or without the field itself? Why this time period?

Are all anthropologists social constructionists, or have we just been reading a lot of those that are?

Juxtaposition between psychological understandings of cultural practice and sociological/cultural ones; can we flesh this out? Is this understanding a ritual from an individual’s perspective, analyzing it as their own personal beliefs and linking these beliefs to their overall cosmologies versus placing the ritual in a cultural context, in which it is instead a method of mass cultural control?

How can we apply Douglas’s insights to medical ritual? How can I apply them to conceptions of pollution around Eureka Springs?
Could use this to analyze the separate spring for ES’s African American citizens.
The water, in the 1890s, began to be marketed as “pure” — could I take this framework and flip it to look at the opposite of pollution? Disease was understood (by some) as a blockage, an anomaly, in the healthy system, and the pure springwater was supposed to cleanse it by breaking down the dirt and flushing it out.
Pathological modernity as a transgression against the body’s natural proclivity to balance and maintain itself. Nature as punisher for transgressions of urbanization/industrialization (clogging up body) and ultimate savior (its waters as cleansing tonics).

Preface to Routledge Classic Edition

Taboos/dirt require “a form of community-wide complicity,” put in place to establish a “local consensus on how the world is organized.” Transgressions need to be understood as avenged by physical nature; “the waters, earth, animal life and vegitation form an armory that will automatically defend the founding principles of society, and human bodies are primed to do the same.” (xi-xii)

Central part of argument — “…rational behavior involves classification, and… the activity of classifying is a human universal.” “Classification is inherent in organization…” (xvii)

Discusses taboo’s connection with risk; both subjective, used by people in power to control behavior. Links work she does with risk analysis and details her foray into applied social theory/anthropology with a policy analyst.

What do we view as risky? What do we view as dirty? All ways of classifying and shaping the world and are subjective and generally culturally specific.


“…dirt is essentially disorder. There is no such thing as absolute dirt: it exists in the eye of the beholder.” “Eliminating it is not a negative movement, but a positive effort to organize the environment.” (2)

“…rituals of purity and impurity create unity in experience.” (3)

We can use taboo/pollution/dirt as a tool to help us uncover the relations between different parts of society, “as mirroring designs of hierarchy or symmmetry which apply in the larger social system.” (4)

“…society does not exist in a neutral, uncharged vacuum. It is subject to external pressures; that which is not with it, part of it and subject to its laws, is potentially against it.” (5)

“Reflection on dirt involves reflection on the relation of order to disorder, being to non-being, form to formlessness, life to death.” (7)

1: Ritual Uncleanness

Douglas is using very “us versus them” language… “contemporary primitives,” “for us…,” “alien religion…” here. Why? That implies that both “us” and “them” understand dirt homogeneously within our own groups. This generalization is what Said was arguing against in Orientalism. This dates this book, unless I’m misunderstanding something.

Discusses late 19th century theologians’ and anthropologists’ theories about religion; took an evolutionary standpoint, where Protestantism (devoid of “magical” and “ritualistic” beliefs and instead based on community ethics) was the zenith, followed by Catholicism, then Islam, onto more primitive religions where ritual was more pronounced.

Early anthropologists drew a line between magic and religion, which is problematic. But the conclusions they came on the demarcation between the sacred and the profane were helpful:
The sacred is abstract, a religious entity, “merely ideas awakened by the experience of society…” and thus must be “constantly hedged in with prohibitions. The sacred must always be treated as contagious because relations with it are bound to be expressed by rituals of separation and demarcation and by beliefs in the danger of crossing forbidden boundaries.” (26-27)

Frazer: magic >> relgion >> science

“…we shall not expect to understand other people’s ideas of contagion, sacred or secular, until we have confronted our own.” (35)

2: Secular Defilement

“Medical materialism” tarnishing interpretation of ritual practices; Douglas has a problem with people taking practices and putting them into a modern medical context. (Leviticus says don’t eat certain stuff because those people must have had some way of knowing that it was actually bad for them!) Douglas is also far from okay with scholars taking the opposite approach, and condemning these rituals as completely foreign to our own ideas of cleanliness/hygiene. (“Our practices are solidly based on hygiene, theirs are symbolic…”)

“…our ideas of dirt also express symbolic systems and that the difference between pollution behavior in one part of the world and another is only a matter of detail.” (43)

Discussion of entrance of uncomfortableness (and sometimes stimulating) effect of anomaly and ambiguity into the individual classification systems that color our perception/understanding of the world.

Culture — collective classificatory systems/understandings — are more rigid, less easily adapted or changed when confronted with anomaly. Usually dealt with in 5 ways:

  1. “Settling from one or another interpretation…”; monstrous births are baby hippos accidentally born to humans
  2. “…physically controlled…”; twins are murdered at birth
  3. avoidance; steering clear of things that crawl on their bellies (Leviticus)
  4. “…labeled as dangerous…
  5. “…used to… enrich meaning or to call attention to other levels of existence.”

“…if uncleanliness is a matter out of place, we must approach it through order.” (50)

3: The Abominations of Leviticus

Argues that the what seem like arbitrary or perhaps medically materialistic restrictions on animals that are prohibited for eating in Leviticus can be understood in terms of an attempt at placing distance between order and anomaly. Animals on the ground, in the sky, and in the water were supposed to be whole and have certain characteristics. If they don’t fall into these categories, they are unholy and to be avoided.

If this interpretation is correct, “the dietary laws would have been like signs at which every turn inspired meditation on the oneness, purity and completeness of God. By rules of avoidance, holiness was given a physical expression at every encounter with the animal kingdom at every meal.” (71)

4: Magic and Miracle

To judge “primitive” religions for ritual practice is hypocritical. Evangelicalism, Douglas argues, is suspicious of religious ritual; but if “…ritual is suppressed in one form it crops up in others, more strongly the more intense the social interaction. Without the letters of condolences, telegrams of congratulations…the friendship of a separated friend is not a social reality… Social rituals create a reality which would be nothing without them.” (77)

“The difference between us is not that our behavior is grounded on science and theirs on symbolism. Our behavior also carries symbolic meaning. The real difference is that we do not bring forward from one context to the next the same set of ever more powerful symbols; our experience is fragmented. Our rituals create a lot of little sub words, unrelated. Their rituals create one single, symbolically consistent universe.”(85)
Again with the us-them dichotomy. Who is this “us”? And “them”? This generalizing is really problematic.

Money, cleaning as rituals.

5: Primitive Worlds

Really confused about this chapter. Douglas seems to be arguing for the conception of societies/cultures as “modern” and “primitive,” and that the only reason some anthropologists have been uncomfortable with this construction is due to a feeling of superiority.

“Differentiation in thought patterns goes along with differentiation in social patterns.” (97)

Argues that “modern” societies are less self-centered, seeking objectivity. Uses analogy of the Copernican revolution, in which men cast off their need to see themselves as the center of the universe and relate all natural phenomena to their immediate selves. Also couches the change in terms of cultural differentiation. “Primitives” don’t see the world this way.

“…our own type of culture needs to be distinguished from others which lack this self-awareness and conscious reaching for objectivity.” (98)

“[Primitive]s’ world revolves around the observer who is trying to interpret his experiences. Gradually he separates himself from his environment and perceives his real limitations and powers.” (100)
This seems to imply that we’ve accomplished this — seen our real powers through objectivity. Pfft.

“…their relation to their environment is mediated by demons and ghosts whose behavior is complicated and unpredictable, while we encounter our environment more simply and directly. This latter advantage we owe to our wealth and material progress which has enabled other developments to take place. So, on this reckoning, the primitive is ultimately at a disadvantage both in the economic and spiritual field.” (115)

6: Powers and Dangers

Discusses witchcraft and sorcery; generally exists in portions of the population that exist in ambiguity, in the cracks. Not easily classified and particularly prone to cause social disorder — even if they aren’t. Their mere existence is uncanny and uncomfortable.

7: External Boundaries

Discusses the body as a site of ritual meaning. Stuff that transgresses the boundaries of the body (spit, piss, blood, shit, sweat, etc.) has significance.

“…when rituals express anxiety about the body’s orifices, the sociological counterpart of this anxiety is a care to protect the political and cultural unity of a minority group.” (153)
Definitely see this in medical spas — thinking specifically of Curing the Colonizers.

8: Internal Lines

“…pollution rules can serve to settle uncertain moral issues…” (162) and help to fill in the gaps to sustain social order where morality falls short.

9: The System at War with Itself

Argues that more primitive social structures are more prone to enact distinct and harsh categories and expectations between men and women. (174)


Water Cures and Science

George Weisz, “Water Cures and Science: The french Academy of Medicine and Mineral Waters in the Nineteenth Century,” Bulletin of the History of Medicine 64, no. 3 (1990): 393-416.

In this piece, Weisz discusses institutional and individual attempts in nineteenth century France to place mineral waters and the therapies that involved them on a biomedical, statistical, and chemical foundation of therapeutic efficacy. He argues that the different way in which spa therapies are understood, utilized, and supported in Europe versus in North America is due to the medical and scientific fields’ support of hydrotherapy in the former, where it is largely absent in the latter.

“Water cures in North America were largely an entrepreneurial activity with limited links to public health authorities and even less to academic medicine.” (394)
He doesn’t cite anything here, so I wonder from where he has gathered this impression. Not that I disagree, but it’d be nice to see where this is discussed elsewhere.

The French Academy of Medicine was put in charge of “authorizing” mineral waters in the 19th century “on the basis of chemical analyses carried out in the Academy’s laboratory.” They didn’t make judgements on the therapeutic efficacy/action of the waters, but just looked at what was in it and compared it to other well-known spots. (396) They added bacterial analyses by the end of the 19th century. (397)

The organization had a branch of inspectors whose job it was to “study scientifically the properties of local waters, to supervise the medical functioning of spas, to suggest improvements to appropriate authorities, and to provide free medical care to indigents.” Their role changed in emphasis from statistics-gathering to the production of original scientific research as the century wore on. (398)

The reports they submitted were gathered, cross-referenced, and published by the Academy yearly (though this was sometimes poorly done and late). “…the aim was to set down information in a logical manner so that correlations among what we would call variables could be made visible. The key question in this case was the extent to which a particular water could be shown to be especially effective against particular diseases or conditions. The goal was to determine each water’s therapeutic specificity…” (398-99)
This is the exact kinda thing that’s going on in climatology. Woot woot!

Weisz spends some time discussing how the reports and the scientific validity they gave the waters were a source of medical authority for the Academy over mineral waters. They advocated for legislation that would prevent people from using the waters without the aid of a physician (this failed — legislation in the early 1860s made waters free to use for anyone).

Spa proprietors were understood as greedy; “the only counterbalance to commercial greed was medical authority.”
Since there was little medical authority in ES, this may explain why the spa industry didn’t take off in America like it did on the continent. Capitalists were permitted to make outrageous claims, and nothing was regulated — they became untrustworthy as medicine scientized. They tried to jump on the bandwagon of scientific legitimacy, but the commercial aspects of their endeavor were too pronounced. Too many unsustainable claims. Trust (particularly of the thin variety, I’d imagine) is a ruthless balancing act. 

The Academy believed that “[t]he prosperity of the spa industry would be ensured if the applications of water cures could be determined scientifically; if a degree of therapeutic specificity were to be established physicians could be made fully to understand the range of conditions for which each water was useful. Explaining the actual mechanisms through which waters acted on the body might be part of this task, but it was secondary to the precise determination of therapeutic efficacy.” (402-3)
This focus on empirical evidence over explanatory theory may have sustained therapeutics through the late 19th and early 20th centuries, but as bacteriology, pharmaceutical chemistry, and other sciences provided a mechanistic (word choice?) explanation, this kind of mass evidence based on “subjective” experience would cease to be as convincing.

Weisz spends some time discussing the difficulties in establishing the extent of therapeutic efficacy; do you take a clinical approach? The variables are very difficult to isolate, particularly for hydrotherapy, where many things are at play. Clinical testing strategies were also in their infancy. The laboratory is another strategy (that became increasingly popular as time wore on), but it is even more reductionist and restrictive. How could you conduct a laboratory test on the community healing aspect of a health spa?

Details attempts at establishing hospitals and laboratories near spa towns, which don’t seem to have happened.

“Chemistry was in certain respects hydrology’ main claim to rigorous scientific status…” though there was some tension between “chemistry adn clinical therapeutics.”

Discusses the case of Forges-les-Bains, a site where chemical testing indicated that the waters had very little mineral content (like Eureka Springs!). The Academy authorized the waters anyway, citing the history of therapeutic efficacy. This was an instance in which, Weisz argues, “…the primacy of therapeutic effects over chemical analysis was affirmed.” (406)
Idea for the conclusion of my thesis (in which I plan to briefly speak on why spa therapies did not take off in America): the fact that Eureka Springs did pretty well despite chemical analyses proving no active agents speaks to the weakness of chemical/hydrological science in the US. 

On data collection, which Hamlin also discusses –
“Collecting data, on the model of public health statistics, seemed in fact one of the few ways to ridge the gap between chemistry and therapeutics by permitting the Academy to utilize inspectors’ reports in order to process these two types of knowledge into data that might conceivably show clear relationships between chemical composition and the healing of particular diseases.”
Hamlin details this same process in England; he refers to it as an attempt, in the Baconian vein, to gather voluminous information about something in order to subsequently construct an underlying theory. I wonder if this was going on in America as well, or if chemistry wasn’t well established enough or interested in different kinds of questions than therapeutics or mineral waters? This could also help shed light on the question of why hydrotherapy didn’t do well in America. If its handmaiden, chemistry, wasn’t organized, authoritative or interested enough to provide solid medical legitimacy, especially considering the active role it played in establishing the science of hydrology in France… there’s no way it could compete with other therapeutic systems. 

Weisz argue that the Academy “helped keep hydrology alive as a scientific speciality in the nineteenth century and invested it with whatever prestige the Academy itself possessed. It also produced a body of medical writing that pretty much confirmed the belief in the efficacy of water cures.” (415)
I don’t think hydrotherapy/hydrology/climatology had similar institutional support. This would be a good argument to make at the end of chapter two; cite the differential in university appointments and commmittees in public health and other government bodies that concern mineral water, hydrotherapy, hydrology, climatology, etc. 

“The scientific effort expended on mineral waters…has in the final analysis been most significant because it has made a clear statement that water cures are valuable enough to be the object of such interest by the medical elite. In so doing, it has helped keep this therapy within orthodox medicine (though far from the center), in spite of the fat that it does not conform easily to the dominant models of scientific explanation.” (416)


Chemistry, Medicine, and the Legitimization of English Spas, 1740-1840

Christopher Hamlin, “Chemistry, Medicine, and the Legitimization of English Spas, 1740-1840,” Medical History, Supplement No. 10 (1990): 67-81.

Hamlin, much like he does in A Science of Impurity, discusses the role of chemistry in the legitimization of health spas. He argues that their domination of the conversation was not due to any sort of revolution in techniques — there were actually a lot of widely recognized problems with analyzing mineral waters — but due to a myriad of factors that included the rise of the profession as a whole and individual chemists’ abilities to assert their ability to explain scientifically and objectively the concrete reasons for different spas’ medical effects.

“Then as now, the appeal to science was grounded in the presumption that it gave access to an objective reality. The effects of a spring whose contents and activity could be accounted for need no longer be tied to the fragile subjectivity of an individual patient, an advantage both to the proprietor of the spring, who then had grounds of guaranteeing the water’s effects, and to the patient, who (at least if he or she accepted the naturalistic ideology that went along with science) might then have greater reason to believe the cure was real.” (68)

Hamlin distinguishes between two different arguments for springs’ efficacy. One, an older version that died out in the 19th century, held that each spring was “conceived as a complicated and changing mixture including a watery principle, various dissolved and suspended salts and earths, a spirit, the ‘life’ or ‘soul’ of the water was called, that transcended analysis or capture.” This was expounded by Friedrich Hoffmann. (71) Even after the rise of pneumatic chemistry, the argument was still being made; “Compositional chemistry was far too feeble an instrument to discover either the true nature of a mineral water or the complicated relations between the water, the circumstances of taking it, and the individual’s constitution that together accounted for medical effectiveness.” (72)
This argument sounds a lot like the pre-1890s arguments for the springs’ efficacy. Science can’t explain it! Chemistry can’t explain it! We know it’s true from testimonials, and that’s good enough.

The rise of pneumatic chemistry in the mid-eighteenth century gave analytical chemists of mineral water explanatory power that greatly increased their ability to analyze and explain the effects of the waters. This provided chemistry with a new authority which “threaten[ed] the equilibrium of charges and rebuttals by representing a neutral and common standard against which claims could be evaluated.” (72) “…by determining the differing effects of spring with different compositions, one could work out the pharmacological properties of each of the different components… one made pharmacological inferences from chemical facts, and pharmacological possibility was therefore reducible to chemistry.” (73)
This argument sounds like later ads. Chemistry tells us that our water is pure, unique, and medically effective; the best analytical chemists can confirm!

Hamlin argues that chemistry came into its own right (“rather than as a collection of medical and technological services that chemists offered for sale”) in the 19th century due to its “rapidly growing importance, a result of the spread of the French chemistry of Lavoisier, the launching of the heavy chemicals industry, and the discovery through electrochemistry of numerous elements…” (77-8)

“Wiht far more unanimity in methods and concepts, and growing loyalty to the profession, chemists were able to promote the idea that mineral water assessment was inherently the business of the science of chemistry, no matter how inadequate for that purpose its capabilities might currently be.” (78)



Medical advertising and trust in late Georgian England

Hannah Barker, “Medical advertising and trust in late Georgian England,” Urban History 36, no. 3 (2009): 379-398.

Baker brings sociological theories of trust to bear on the proliferation of medical advertisements in the late 18th and early 19th centuries in four English towns. Using a statistical approach, she evaluates what sorts of rhetorical strategies were used to advertise patent medicines and asks what this can tell us about the people that were purchasing the tinctures and their construction of trust.

Like most of the articles I’ve read today, this one isn’t quite relevant due to its earlier and European (specifically British) focus. Also like the other pieces I’ve read today, however, the approach and language used could prove very useful to my study.

Though Barker claims she is getting at the patient’s perspective (unlike most others who have written on medical advertising), I’m not convinced that she successfully does this. Her approach is very top-down as well. It is notoriously difficult to tease out of advertisements — really a one-way conversation — what the people who were reading and responding to them may have felt about them.

Barker argues that there was a relative absence of concern with professional or elite voices in testimonials; she breaks them down and finds that only about a 18-24 per cent of testimonials appealed to a medical authority in any way. Instead, she asserts that more important in the testimonial was the establishment of a more distant substitute for thick trust (that established through familial, friendly, and neighborly, face-to-face relationships). In an increasingly urban, industrial way of life, this thick trust was harder to come by. People had to start trusting people and institutions they did not intimately know.

Letters were common in newspapers of the time, but they were often signed with pseudonyms. This was not the case for testimonials, where the name, location (majority), occupation/social status (~50%) were given.

“The tendency to include both the name and the location of testimonial writers… offered readers the chance to confirm stories they told either in person or by post, hence reassuring the reader that a more direct affirmation of a product was possible (even if it was never followed up).” (392)

In a study of Victorian advertising, Lori Anne Loeb has described the public testimonial as making readers feel part of a community of consumers whose collective experience engendered confidence in a particular product. The sorts of testimonials that appeared in medical advertisements in the earlier period under discussion here c an be seen in similar terms, by allowing a form of ‘remote’ face-to-face encounter, which provided the reassurance of receiving evidence that a medicine worked from a real person, even if one did not actually meet them. What is most notable is that the ‘real person’ in this instance was not a medical practitioner, nor were they necessarily a member of the social elite, but an individual who typically appeared in print with no indication of his or her social standing or of their expertise to comment on medical matters. Indeed, it is implicit in most testimonials that writers had no medical training and were unconnected to the medical trades and professions. Testimonials were supposedly provided by individuals who were willing to publicize their cures and have their names in print, but who — in the main — were distinguished only by their ‘ordinariness.’ In this way, testimonial writers appeared to stand in for those day-to-day contacts who would have provided the type of word-of-mouth reputations on which most people might have depended previously, aping something of the ‘thick’ forms of trust that were more prevalent when towns were smaller and their populations less diverse and unconnected. (396)

I think this kind of thick trust could also be refreshing for “victims” of heroic medicine in the late 19th century. Distant medical theories, doctors who let their patients’ bodies speak for them, may have engendered a longing for this kind of deep, communal medical trust. 

Next time I look at my testimonials, I may attempt a similar breakdown. What sorts of information is presented? Name? Age? Location? Social status? Profession? What can the absence of certain categories tell me about what the average Joe felt he needed to establish trust in someone/something?