Arkansas Medical Monthly (1880)

“Eureka Springs.” Arkansas Medical Monthly 1, no. 1 (1880): 1-3.

“Notwithstanding, however, the ludicrous aspect placed upon the reputation of these springs in the eyes of the medical profession, induced by the enthusiastic exageration [sic] of the people, there is evidently something about them worthy of our attention and careful inquiry.” (34)

“We visited the place during the latter part of December last, but owing to the fact that no analysis has as yet been made of the water (or, at least, none has come under our observation), it is impossible to base a scientific opinion upon its proposed therapeutic value.” (34)

Discusses having talked to a lot of people that had been or were in the process of being cured

Water, according to the experience of the writer, has “strong laxative and diuretic properties.”

Gives altitude, says air is “proportionately rarefied,” and that this combined with the effects of the water may account for beneficial effects on consumptives — should get same results in ES as you would in the “extreme west, i.e. Colorado, California, New Mexico, etc.”

Only providing the info “in order to satisfy public curiosity” and hopeful that “a scientific investigation as to the true causes which induce so much enthusiasm in regard to the ascribed curative properties of this water.” (35)

J. J. Jones, Sr. “Letter from Eureka Springs.” Arkansas Medical Monthly 1, no. 3, ed. Jonathan J. Jones (1880): 147-149.

Jones claims he went to ES skeptical of the outlandish claims, but has found this “delusion dispelled.”

He found a lot of people cured, even some which had been pronounced incurable by “prominent members of the medical profession.” He quickly tempers that assault on his fellow doctors by claiming many uncured invalids remained so due to their “constitut[ing] themselves their own medical advisers–ignor[ing] the medical profession until prostrated or nearly dead, when, in all probability, if they had obtained timely advice from some competent physician they would have improved from the first.” (147-8).

Establishing objectivity: Jones claims to “speak from observation and experience,” stating on several occasions that he has no ulterior motives in promoting the town and that he was not enthusiastic going in to his survey.

On chemical analysis: Because the first analysis failed to adequately explain the medical effects of the water, Jones finds fault with the way it was conducted; water was taken from the springs and transported to a lab in St. Louis. “Another analysis will be made at the Springs shortly, which is the proper place for it to be made at, as probably some active ingredient may be lost or dissipated in its transit.” He leaves open the possibility, however, that analyses may be inadequate to explain the water’s properties. “Although every analysis may fail to discover its active ingredients, yet the facts are demonstrable, unmistakably so, that it produces the effects attributed to it. Thousands are here to-day ready to testify to it.” (148)

“Eureka Springs.” Arkansas Medical Monthly 1, no. 3, ed. Jonathan J. Jones (1880): 134.

Gives the analysis by Wright & Merrill (St. Louis); was evidently requested by Dr. B. M. Hughes of Eureka

“This water is remarkable for its purity, as its specific gravity, which is at 60 deg. F., only 1.000103, and the small amount of solids found, plainly indicates. In this respect it is very similar to the celebrated medicinal waters of Baden in Germany and Pfeffers in Switzerland.” (134)


Intimate Climates

Vladimir Jankovic, “Intimate Climates: From Skins to Streets, Soirees to Societies,” in Intimate Universality: Local and Global Themes in the History of Weather and Climate eds. James Fleming, Vladimir Jankovic, and Deborah Coen, 1-34 (Sagamore Beach: Science History Publications, 2006).

In this chapter, Jankovic is interested in the dichotomy of the indoor/outdoor and in understandings (from literary and medical sources) of weather before the mass quantitative study of it really took off. He is particularly interested in indoor environments, an understudied aspect of weather — “intimate meteorologies.”

!!!Probably the most well-written and cited introduction to revival of interest in “air, waters, places”-type medicine at the end of the 18th century!!!

Medical meteorology — “a genre devoted to understanding the relationship between the body and its socio-physical surroundings that in the last decade of the 18th century consumed the energy of the ever-growing numbers of practitioners seeking to resolve an impasse created by the ineffectual heroic treatment and the perplexing pharmacopoeia of the medicinal market.” (1-2)

Outlines argument in scholarship that “a wide-ranging interest in the quantitative investigation of the properties of airs, gases, atmospheres, and climates,” especially in regards to human health — “environmental medicine” (Ludmilla Jordanova), “medicine of climates and places” (Michel Foucault), “environmental paradigm” (David Arnold), “environmentalism” (James Riley) — emerged “some time before the year 1800.” This interest is made visible by the rising interest in the sciences of “eudiometry, medical topography, altitude physiology, medical pneumatics, gas chemistry, and climatotherapy…” I’d add hydrology/hydrotherapy and balneology. (2)

Argues that early (pre-1830s) interest in meteorology and quantifying weather was driven by medical concerns. (4-5) Most people gathering data early on were doctors in hopes of providing others with medically-informed referential material for use in choosing a residence (and I assume a vacation/resort spot).

Posits that “the analyses of health as a result of” the direct influence of air, soil, water, climate, topography, temperature “on individuals and populations…emerged as the principal new development with thin 18th and 19th century Hippocratic medicine,” and that “on the mundane level, the practices related to mitigating these influences had a more lasting influence on the rise of an ‘environmental’ outlook than chemical and epidemiological investigations.” (7)

Pretty sophisticated discussion of sensibility; the more sensitive, the more open the body was to outside influences (air, climate, water, etc.). Weaker constitutions were more sensible and more at risk when changes in surrounding occurred. These theories were developed in Scotland (Edinburgh) and France (Paris). Challenged autonomy of individuals – climatic/environmental determinism. Became part of wider discussion (political, economic, moral). (8-10)

A problem of the wealthy: Sensibility became a problem of the wealthy, whose “artificial/abnormal…new spaces of lifework,” characterized by “urban consumerism, sedentariness, indolence, and fashion” were detrimental to their health. Commentary came from many directions; medical, literary, political. “The peasant archetype became the medical norm against whom the unnatural urbanite was measured in both moral and organic terms.” Because they never exposed themselves, they became extra-sensitive when they did. (11-12)

  • The “hypersensitive body [was] defined as culture-determined and class-based,” which meant that to suffer from it “could not but become and achievement that marked a select few…” (18) And so going to a resort was affirmation that you suffered from these ills, and participating in “society” while there reaffirmed and reinforced social status.

People were spending more and more time in artificial, indoor places — industrialization meant longer working hours. City life meant less time outside. New communal public spaces — coffee houses, lecture theaters, clubs, card rooms, libraries — were overcrowded and smelly, causing “overheating, fatigue, and depression of spirits resulting from congestion.” (13)

Description of how people hung out, which was changing in the mid- to late-18th century. Wallpaper, carpets, curtains, candles, and parties with a ton of people in one room. Would have been hot, cramped, stuffy, and quite unhealthy — even in today’s standards (and much moreso contemporaneously considering the medical paradigm we’re working with). (14-15)

“The sensitivity to air that informed the early-19th century interest in weather as an outdoor phenomenon was in some important elements defined by its indoor- and body-oriented origins. It reflected the medical implications of social and geographic placements that defined the vulnerability of the self-styled modern man.” (18)

Urban pathologization: “…the early 19th century medics constantly emphasized the artificiality of the newly created spaces of work, sleep, and the bacchanal. In their view, these spaces deteriorated not only pathologically — measured in statistics, sights, and smells — but primarily because they transgressed the normal contours of morbidity found in the places governed by divine dispensation of health and disease.” (19)

  • Goes on to discuss moral and physiological consequences of aggressive and greedy industrialization — understood typhus as a consequence of “the overstretching of natural powers.” (20)
  • Natural weather less important in urban areas; the unhealthfulness of industry trumped, overtook “natural” conditions

Selling Air

John Beckerson and John K. Walton, “Selling Air: Marking the Intangible at British Resorts,” in Histories of Tourism: Representation, Identity, and Conflict ed. John K. Walton, 55-68 (Channel View Publications, 2005).

In this chapter, Beckerson and Walton analyze promotional material and medical/scientific opinion on air as a draw to different health resorts. They describe its link to the philosophy of climatic determinism, highlighting the different kinds of air publicists from different countries marketed as being salubrious. They seem to constrain their analysis to sea air and to England, which renders the chapter a bit less useful for me. The work is mostly descriptive.

“The selling of air… was not the same as the marketing of a health-giving climate, which dealt in the statistics of sunlight, rainfall, humidity and prevailing winds: this was a qualitative issue, dealing with the perceived characteristics of the air of particular places and its alleged capacity to invigorate, rejuvenate, or sustain those who breathed copious doses of it.” (55)

Asserts that most middle-class families could afford health leisure trips by “the later 19th century,” and that businesses began to cater to them. (56)

“…the qualitative assertions favored by the publicists were impossible to disprove.” (57)

Popular attributes for the air: “ozone,” “bracing,” (<–dry) “tonic,” (<–“lifting the spirits and stimulating the appetite”) “strong,” “brisk,” “invigorating,” “bromine/iodine”
Ozone was associated with ocean air and believed to be impregnated with seawater’s health benefits. A lot of seaside resorts used it as a central marketing point, as did some rural ones. Though ozone’s salubrity found some backlash in scientific circles, it maintained a presence in promotional material for health resorts well into the 20th century. (58-9)

“As with ozone, the label ‘bracing’ could be presented as part of a broader and quite sophisticated-looking medical analysis of the properties of air in different local microclimates…”
Qualitative assessment of air used to bolster medico-scientific analysis of the salubrity of a resort. Keywords — bracing, ozone –important!

“The Americans tended to stress relief from urban heat and humidity.” (61)

Bit on how local flora and fauna made up part of advertisements, which made sense in a cultural context in which discovering the natural world improved a holiday — “It was a sign that the resort was a place where the city and its threats to health and vitality could be escaped.”
In this way, America and Britain are the same. Health holiday in a rural setting in order to escape the pathologies of the city.

Municipal efforts at advertising “…were a useful gauge of how towns chose to collectively present themselves and reveal which groups had the power to form and sell images of place.” (62-3)

“Bracing breezes were difficult to measure and compare competitively but were only one aspect of competitive resort propaganda about weather and climate. A veritable climatic war was aged over many decades with rainfall and sunlight statistics, which could be recorded and presented with some claim to objectivity.” (63-4)

Attempts to harness scientific/medical authority —

  • Medical men were often courted as well as potential clientele (ex. The Isle of Man’s Official Board of Advertising, formed in 1893); marketers were hoping to get recommendations from physicians. (64)
  • “Assertions about the distinctive qualities of local air played their part in the propaganda, as Medical Officers lent their scientific aura to the vaguest of claims.” (64)

The Politics of Medical Topography

Harriet Deacon, “The Politics of Medical Topography: Seeking healthiness at the Cape during the nineteenth century,” 279-297, in Pathologies of Travel eds. R. Wrigley and G. Revill (Amsterdam: Rodopi, 2000).

Deacon focuses primarily upon the imperial, moral, and economic reasons that Cape Town faded as an important health resort spot in the 19th century. It was longer on an important trade route and was unable to compete with Mediterranean or, more significantly, European health resorts in society and status.

I didn’t find a whole lot useful here, mostly because the focus was not on the role that science played in the Cape’s downfall (and attempts to remain relevant). Deacon spends a lot of time fleshing out the moral implications that the developing city with few aristocratic or other high-ranking imperial officials seemed to have for some of those who commented on it. While its climate was originally held to be quite healthful, the discourse on climate and its deterministic role in the making of the individual increasingly cast doubt onto the location’s healthfulness. Deacon argues that this change was one explained better by imperialistic and economic motives than medical or scientific ones.

In her brief description of the state of the environmental understanding of medicine (neo-Hippocratism) is interesting. It reinforces the assertion I have seen elsewhere that, contrary to some more teleological narratives of the making of modern bio-medicine, the germ theory of disease did not overtake or even hinder a more holistic understanding of health and disease prevention. “Environmental disease aetiologies, in both meteorological and sanitary forms, were so powerful that they were able at first to incorporate, and later exist alongside, germ theories of disease, especially in popular culture.” (281)

Deacon does describe an attempt by the Cape Government to legitimize its value as a health-resource through the collection of information about the climate and its “beneficial effects in many complaints.” (290) Unfortunately, she does not go into any depth; I wonder who collected the statistics, if they were gathered together and republished by an agency, and if any sort of marketing occurred. Did the marketing rely on the gathered information? In any case, the government and medical board turned to scientific, quantitative methods in the latter half of the 19th century to try and keep their resort relevant in a medical world increasingly dominated by a new, scientific epistemology.

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)