“On the Frontier of the Empire of Chance”

Arwen Mohun, “On the Frontier of The Empire of Chance: Statistics, Accidents, and Risk in Industrializing America.” Science in Context 3 (2005): 337-357.

In “On the Frontier of The Empire of Chance,” author Arwen Mohun examines the rise in statistics and probabilistic thinking in the American vernacular context from the late nineteenth through the early twentieth centuries. Through the lens of a cultural historian of technology, Mohun takes a closer look at how the industrial-era quantification of risk altered the way people understood it; she asks why and how this transformation took place, and then delves into how these understandings were shaped and used in order to mold individual behavior and enact widespread change. Mohun argues that the actors in her narrative existed on the periphery of the Empire of Chance. While experts, primarily located in European centers of statistical theorizing, formed the “epicenter” of the empire, those on the frontier employed statistics as a tool in social manipulation. Far from relegating popular audiences to a primarily observational, inert role, however, the author also acknowledges their agency in the story by explaining how their motivations affected their choices regarding risk and reward.

Obviously, Mohun’s work builds off of the book she references in her title — The Empire of Chance. Her piece is different from that of Gigerenzer et al., however, in that it addresses how the methodological and intellectual developments of professional statisticians found their way into popular understandings of variability and the risks associated with it. This is reminiscent of Dr. Pandora’s assigned reading for her two weeks of 5990 at the beginning of the semester — Spectacular Nature and The Whale and the Supercomputer. Like Mohun’s work, Susan G. Davis looks at how ideas from the “top,” the professional scientists, filter down into the vernacular through institutions like SeaWorld. Mohun also looks at how institutions influence the way that popular audiences understand scientific theories, their consequences, and their uses. In contrast, Charles Wohlforth focuses on how non-professional ways of knowing had a major impact on the way scientists looked at and understood climate change in the arctic. Mohun mimics this approach when she includes in her analysis how the importance of individual experience affects the way that the average American understood and behaved in regards to risk-taking. When the approach involves popular science, both perspectives — top-down and bottom-up — are important for a holistic understanding of how science and vernacular audiences interact and influence one another, and in this regard, Mohun as clearly covered all of her bases.

Something I found particularly interesting in this piece was the discussion of the “pragmatic approach” to science that Mohun discusses primarily on pages 339 and 340. She argues that it was especially characteristic of American statisticians in the time period she covers, and cites as evidence their absence from histories of statistics. American statisticians worried less about developing sound theories and methods and more about applying their knowledge (no matter how unsound or theoretically dubious) to real-world problems. This embodied what I have come to understand as being a very Industrial-American ideal; the self-made, self-trained practitioner unconcerned with the useless, bookish knowledge so characteristic of their less hard-working, impractical European counterparts. I wonder if the different approaches caused animosity between American and European statisticians; they were obviously sharing ideas. What did these conversations look like, and how did they take place? Was it common for Americans to train abroad, or were universities in America training these frontiersmen of the Empire of Chance?

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The Empire of Chance

The Empire of Chance: How Probability Changed Science and Everyday Life, Gerd Gigerenzer, Zeno Swijtink, Theodore Porter, Lorrain Daston, John Beatty, and Lorenz Krüger

            In their collaborative work, authors Gerd Gigerenzer, Zeno Swijtink, Theodore Porter, Lorrain Daston, John Beatty, and Lorenz Krüger attempt a cohesive study of how the science of statistics “transformed our ideas of nature, mind, and society.” (xiv) The first three chapters present a timeline on which the intellectual development of the science of statistics — with some consideration of its particular applications — is situated, the middle three deal with statistics in particular fields, and the last two concern broader implications of statistical analyses, ideologies, and methodologies. A central theme of the book is the idea that the science of statistics was both shaped and shaped by the sciences that it aided and that helped to develop it for their own explanatory and predictive goals. Professing to be the first of its kind, the survey offers detailed technical descriptions and examples that flesh out the mathematics and theories with which its actors are working.

The passages dealing with mid-nineteenth century debates surrounding the viability of statistical methods for physicians reminded me of S. Lochlann Jain’s criticisms of the same methods in her work, Malignant. Jain and her unlikely intellectual compatriots cite similar issues with the “numerical method” in medicine; it denies the complexity and uniqueness of the individual patient, aiming “not to cure the disease, but to cure the most possible out of a certain number” (Risueño d’Amador, 1836, 46). This results in the emotions Jain so skillfully articulates in her first-hand account as a cancer patient. Reduced to numbers, cancer sufferers are identified by the statistical methods their doctors use to diagnose and treat them. Equally concerning is the reliance of pharmaceutical companies on results from statistical studies to produce drugs that will target cancer on a broader scale, to the detriment of patients who would have benefitted from more personalized treatments. Perhaps these nineteenth century critics were not off base in their hesitancy to adopt such a dehumanizing method of handling disease.

Another bit I found particularly interesting was section 3.5, “Hybridization: the Silent Solution.” Having taken statistics and seen it in what I am now realizing was a surprising amount of my undergraduate science classes, I was struck by the fact that the statistical methods we learn as absolute and established are in fact far from it. Integral tenets to the type of statistics I was taught are, in actuality, theoretically at odds with one another, and yet, as the authors contend, “Statistics is treated as abstract truth, a monolithic logic of inductive inference.” (107) Because statistical methods are so widespread, I find it both surprising and alarming that these obvious impediments to its image as a well-established and unproblematic method of analysis are kept more or less hidden. It lead me into thinking about how oftentimes, when scientific disciplines are “successfully” mathematized, we deem them somehow more intelligible; they become more solid, their results more trust-worthy. Is this a valid logical jump to make, especially if statistics, one of the mathematical sciences that is employed most often, rests on shaky ground?

Disease as Framework

Medical historians, medical anthropologists, and other scholars concerned with a plethora of topics have written works centered around specific diseases; what comprises their arguments, evidence, and conclusions, however, varies greatly and begs the question, what exactly is the history of a disease, and how have scholars employed disease as a schema through which they analyze other topics? This essay will attempt to provide specific examples of historians (and anthropologists and literary scholars) using illness as a framework, and it will elucidate the benefits, drawbacks, and consequences of such work.

Few medical historians would argue with the statement that a disease is a constructed entity. The biology of an illness constitutes only a part of its meaning to the society from which it emerged. Oftentimes, there are non-biological factors — “beliefs, economic relationships, societal institutions,”[1] to name a few — that also make up the concept that is a particular disease. Syphilis is a good case in point. The biology of the disease is fairly standard; it is a bacterial infection that, if left untreated, can become quite serious. Because of the way that it is transmitted, however, syphilis has garnered a scandalous reputation and has been associated with sin since its appearance in Europe in the late 1400s. The way the disease was handled institutionally (syphilitics were often banned from hospitals or placed in homes amongst one another) and the way that sufferers experienced it (often shunned from society, and when treated at all, given needlessly harsh “remedies”), shows that it was, at least in the eyes of the religious societies it ravaged, much more than what its biological attributes would suggest.[2]

If, then, diseases carry in their conceptions more than their biologies, studying the way that people, institutions, practitioners, and societies in general interact with illness can tell us a lot about that society, and by centering their work around certain diseases, historians can look at the specific aspects of society those diseases’ definitions are ingrained within. A study of syphilis, for example, would prove insightful to a historian looking at religion, morality, and sexuality, as these abstract principles were entwined within contemporary understandings of the disease. Anyone commenting on syphilis in the fifteenth and sixteenth centuries was likely to have something to say about the immorality and sexuality of the sufferers, as juxtaposed with the more religious individuals who kept the scourge at bay with their superior righteousness and adherence to stricter moral codes. Disease can help a historian tease out the more intricate, sometimes contradictory beliefs societies and individuals have held, and as a universal if not experience, at least anxiety, disease is something that everyone — rich or poor, young or old, educated or illiterate — would have run into and held assumptions about.

The universality of disease does not imply that the experience of disease has been homogenous. As some of the works included in this essay will attest, disease has played into already extant lines of difference between segments of a population. It can isolate and stimulate discourse on these populations at the fringes of society; German measles did so for women and for the disabled, as Sickle Cell Anemia did (and continues to do) for African Americans.[3] It can bring visibility to groups of people, prompting humanitarian action, as cholera did for some of the poorest individuals in nineteenth century New York.[4] It can also serve to condemn, as many believed AIDS did when it struck down a disproportionate number of homosexual males during its rampage in the 1980s.[5] Whatever the case may be, it is clear that diseases can tell many stories, and as such provide an excellent avenue through which historians can understand the social, economic, political, and medical dynamics of a group of people.

The stories a disease tells are greatly influenced by which division of an affected population the writer chooses to vivify and how those individuals interacted with the illness (or the ill) themselves. A primarily institutional perspective, such as the one adopted by Charles Rosenberg in The Cholera Years, will provide insight into major ideological trends; state and national responses to the cholera epidemic in the mid-1800s included prayer and fasting, while just a few decades later, methods from the public health sector (quarantine and cleaning cities) dominated the institutional response. This outlook can highlight major changes in theoretical and practical understanding and in who holds institutional power (in this case, the medical experts or theologians). While this method offers much by way of the ideological leanings of the academically and socially significant members of the populace, it also leaves many actors out of the narrative. The experiences of the practitioner and the invalid factor very little into these stories, to the detriment of their plenitude.

In contrast, an author may choose the opposite route and focus instead on the experience of the afflicted, as S. Lochlann Jain does in Malignant. This method offers in-depth analyses of the experience of the disease itself — it answers questions about what was and was not available to sufferers, and how they were treated by their friends, families, doctors, and governments. Jain exposes corporate fundraisers for cancer research as short sighted and opportunistic, just as she points out inconsistencies and holes in the healthcare system for young adults (the seemingly healthiest segment of the population). Her unique perspective comes from someone having dealt with the disease firsthand, and the insights she offers as a result circle primarily around that perspective. It is quite powerful, but like all viewpoints, it is not universal, and it fails to elucidate the institutional standpoint; the doctors who treat cancer day after day, for instance, do not have a voice in Jain’s work. It is extremely difficult to trace larger trends in theoretical, scientific, or practical understandings held by the scientific community, the government, or various medical associations from the sole perspective of those they attempt to care for.

The final potential perspective of disease lies with those who probably spend the most time surrounded by it — the practitioner. In some ways, the perspective of the doctor encompasses both the institutional narrative and the personal one. The practitioner can serve as a go-between, as a representative of larger medical and governmental bodies who brings institutional wisdom to the commoner. By the same token, doctors can provide those suffering with a voice in an institution; in many nineteenth century epidemics, for instance, it was the doctors of a town, not the government, who provided the impetus for a public health board and suggested quarantine or cleaning measures. It would seem that this perspective would be ideal, but doctors often have outside motivations such as professional advancement (or establishment in the case of pre-twentieth century practitioners), political agendas, and personal belief systems that influence their treatment of certain patients (many doctors during the AIDS epidemic, for instance, felt they had little responsibility to treat a disease caused by sinful homosexuality).[6] Their perspective must be subject to the same sort of scrutiny one would employ when analyzing any story told from a single viewpoint and is best supplemented with others.

Most of the works in the following analysis employ multiple perspectives in telling their histories of disease, but each work tells a story that might have been told many different ways from different perspectives. What the author chooses to include — whose story of illness they decide to impart — depends upon what other entity, idea, or phenomenon they are attempting to understand. By using disease as a framework, the following authors are playing on the intersections between the wider, socially constructed definition of a disease and the society and time that experienced it. Through the excited, fearful window disease offers into the past, the following books, by utilizing the various perspectives offered, paint pictures that, while certainly include the diseases themselves, also give form to other processes, phenomena, and belief systems that constitute the societies whose reactions form the bases of the studies.

The Cholera Years

The first work to be dealt with here is Charles Rosenberg’s dissertation-turned-book The Cholera Years: The United States in 1832, 1849, and 1866. It is first not only because it is a stellar example of disease as framework; it was also trailblazing, as evidenced by the fact that many of the other pieces dealt with cite it when describing their methodologies. As one of the first works to use heightened disease anxiety (most often in the form of an epidemic), Rosenberg’s work presents an excellent starting point. The book is predictably divided into three sections, one devoted to each outbreak, and focuses on the different governmental and sometimes institutional reactions to each subsequent epidemic.

The post-colon portion of the book’s title betrays the focus, on the United States in three snapshots in the nineteenth century, instead of on cholera itself. The outbreaks, Rosenberg states in the introduction, “represented a constant and randomly occurring stimulus against which the varying reactions of Americans could be judged.”[7] In other words, each time cholera threatened the nation, Rosenberg could trace the reactions of its citizens and compare them with those before and those after. By using cholera as a framework of analysis, he could reach an understanding of societal changes, and, he asserts, the processes that brought them about in mid-nineteenth century America.

Rosenberg focuses on a few particular changes he sees through the reaction to cholera. First and foremost, the religious dimensions of the response, he claims, see marked change from 1832 to 1866. The piety so characteristic of Jacksonian America had faded to the background by 1866, replaced by a rise in materialism. This he traces through responses to cholera epidemics, in which he finds the clergy having decreased authority, and an increased tendency to fault uncleanliness as opposed to alcoholism and other, unrelated vices as cause of cholera emerges in newspapers and commentaries by medical and governmental authorities. Another line of theoretical change Rosenberg defines in his study is that of disease causation. In 1832, cholera was seen as a miasmatic entity that, in combination with uncleanliness and immorality, brought down primarily the poor and filthy. By the 1866 epidemic, however, most physicians believed that cholera was indeed a specific disease, caused by the ingestion of “some quantity of a specific poison,”[8] although the exact nature of its constitution would have to wait until 1883 when Robert Koch isolated the true culprit, Vibrio cholerae.

Dangerous Pregnancies

            Leslie J. Reagan’s Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America is a book about the German measles epidemic of the 1960s in America, although the disease around which the book is centered does not even make the title. This is because, as Reagan reveals in her introduction, the book uses German measles as a framework of analysis:

“This history investigates these cultural products and effects and uses the disease to identify the approaches of American parents to pregnancy and family, the role of ordinary Americans and patients in the creation of law and political movements, the state’s relationship to the responsibilities of its citizens, and the development of citizen rights and expectations.”[9]

Her work, while made possible by an epidemic, does not find its center around the disease that ravaged the American family in the mid-twentieth century. Instead, her book aims to understand the many effects this event had on those it touched (directly or remotely); because it affected childbearing women, an integral part of the population, it had direct ramifications for the political and social atmosphere of 1960s America.

Dangerous Pregnancies, with a source base that includes newspaper articles, court cases, images, educational pamphlets, and magazines, encompasses many angles of experience. Mothers of disabled children find a voice in magazine articles, just as scientists and medical professionals are represented by specialized medical literature and government documents. Images feature prominently in the text, because, as Reagan asserts, they “produced a dominant cultural climate that gave shape to people’s understanding of German measles, its consequences, and the possibilities for social change.”[10] The author is attempting to paint a portrait of 1960s America — one that could only be possible in such vivid detail through the window provided by the German measles epidemic.

Through this window, Reagan is able to discuss the unique climate that German measles helped provide for the burgeoning reproductive rights movement. She artfully discusses how the biology of the disease — a biology that allowed it to cross the placental barrier and mark fetal development — produced unprecedented anxiety about fertility and the future, particularly potent in a post World War II America that was already rife with concerns about its ability to maintain power internationally. What made German measles especially unique, Reagan argues, was that it became associated with the white, middle class, a trustworthy group that garnered much attention and sympathy from laypeople and professionals alike. When white, heteronormative, wealthy women had need of abortions, a social movement to provide them legally resulted. This is starkly juxtaposed with the difficulties African American women often found when attempting to undergo the same procedure. In this case, a disease-based framework helps us to understand the ability of a respected, trusted group to enact social change under the ominous threat of debilitating illness, while at the same time pointing to the flagrant undercurrent of racism that continued to marginalize and deny equitable medical care to certain segments of the population. The contrast is stunning.

Dangerous Pregnancies is probably the most inclusive book surveyed here as far as breadth and integration of multiple perspectives go. Unlike some of the other works discussed in this piece, Reagan’s does not neglect the scientific side of the story. She includes in her narrative the development of a vaccine for German measles, and doctors’ and government officials’ thoughts and statements feature prominently. Reagan addresses race, class, and gender issues; she even throws in a few anecdotes that bring in the male experience of the disease, although her primary focus is on women’s encounters. The inclusion of legal proceedings, a rather atypical source base, gives a voice to customarily hidden actors like Sandra Gleitman and Barbara Stewart, two relatively normal American mothers who were told by their doctors that their contraction of German measles early on in their pregnancies would have no effect on their children (which was well known to be medically untrue). By incorporating the patient, the doctor, and the institutional perspective, Reagan offers a wholesome and well-researched portrait of a society, its culture, and the development of its laws, all through the use of a period of heightened anxiety made possible by a disease and its contemporary cultural understanding.

The Collectors of Lost Souls

With Warwick Anderson’s book The Collectors of Lost Souls, we transition into a different research tradition, but one that also utilizes disease as an explanatory tool. Anderson was trained as an anthropologist, and his work could be considered history of science, history of medicine, and/or medical anthropology. The conglomerate approach seems appropriate, however, as the story Anderson tells is itself interdisciplinary. His study traces the American and Australian discovery and subsequent research of a disease and a people living in the eastern highlands of New Guinea, placing emphasis on the interactions between the two groups, the commodification of Fore body parts (brains in particular), and the development of scientific and institutional understandings of kuru, the disease that came to be identified with the islanders. Anthropologists, virologists, and myriad other specialists were involved in the gathering of samples for study and transporting them to laboratories capable of the research, the physical experiments and trials run in order to understand the cause of the disease (for which there is no known cure), and the public health efforts aimed at stymying the epidemic by informing the Fore of its cause — their practice of cannibalizing their dead.

Anderson’s approach mirrors the others in strategy. In his introduction, he identifies kuru as a “social sampling device,” and “[a] potent stimulus to scientific activity” capable of “capturing the culture of biomedical investigation in the second half of the twentieth century.”[11] Scientists keen on making their reputations flocked to research opportunities like kuru presented, and for good reason; Stan Prusiner, the man who isolated the pathogenic protein fragments that caused kuru, won a Nobel Prize for his work on the disease in 1997.[12] Anthropologists jumped at the opportunity to conquer a new research frontier. The disease provided the impetus for the intense anthropological and medical investigation that ensued, furnishing a reason for the Fore and the scientists that descended upon them to interact, exchange goods, and form relationships.

Anderson uses the environmental set-up kuru created to comment on the dynamics of specimen isolation, creation, and distribution that was characteristic of the scientific investigation of kuru and of biomedical investigation in general in the late twentieth century. Field scientists operated as nodes in a network of exchange that included the kuru and remote laboratories and that was populated by specimens taken from kuru bodies. D. Carleton Gajdusek, a field anthropologist that features prominently in Collectors of Lost Souls, traded goods from the first world with the kuru in exchange for their deceased’s body parts, which he then traded within institutionalized scientific networks for professional prestige. Through an intense analysis of this dynamic, Anderson is able to pull apart and understand the intricate social implications inherent in both channels of exchange, and by juxtaposing them, provides deep insight into the complex colonial relationships developed in a twentieth century research hotspot.

Like all the works in this survey, Anderson’s use of disease as a framework makes visible a dynamic cast of characters; his scope of analysis includes the field anthropologists and scientists who interacted with the kuru, the scientists analyzing diseased samples in laboratories around the world, and occasionally the institutions sponsoring the research. The kurus’ voices are less animated than some of the others in his narrative, and although this seems to be a problem with available source material rather than one of methodological deficiency, their relative silence is problematic. How can we truly understand the dynamics of exchange between a native population and medical colonizers without the voice of the former? While it has its problems, Warwick Anderson’s use of kuru as a device to capture twentieth century science’s imperialistic nature and its toleration of commodification of the colonized was overall successful. It was in the unique medico-scientific environment provided by kuru that medical imperialism could flourish and first world scientists could be confronted and changed by their interactions with a culture and its socially constructed diseases.

Malignant

Also coming from an anthropology background, the next work’s author, S. Lochlann Jain offers a firsthand account of her experience with cancer. Filled with snarky social commentary, Malignant is another example of a book that uses a disease’s many tendrils into the social and cultural landscape to analyze chosen aspects of society. While less of a historical work than the others featured here, Malignant provides an opportunity to understand how a more personal account — written not with patients’ perspectives in mind, but by an actual patient — can be useful. Jain’s insight into the medical establishment and the cultural and social experience of someone with cancer is something that the institutional and professional perspectives could never shed light upon. Through Malignant and Jain’s sharp, penetrating work, we can understand what a patient’s perspective has to offer, and, equally important, what it does not.

In her introduction, Jain works very hard to emphasize the cultural understanding of cancer; its biology is mentioned only in reference to how it gives the disease meaning in the context of society. Cancer, she argues, is difficult to define because it encompasses so much more than its biology. “[A] devious knave,” “cancer” is composed of the treatments (and their effects and stereotypes), an entire research industry (that chooses what to research and has a plethora of motivations that do not always include a cure), political groups lobbying for or against carcinogen regulation, and the politicians that choose what approach the government should take on the devastating scourge, just to name a few entities, technologies, and people involved. And yet, Jain points out, we do not have a cure, “…despite some of the shiniest, priciest, most marble-staircased hospitals in the country.” Cancer becomes a noun seemingly too simplistic to envelop the myriad meanings it evokes.[13] It is, in Jain’s words, “not… a disease waiting a cure, but… a constitutive aspect of American social life, economics, and science…a process and… a social field.”[14]

Cancer as a complex medico-cultural entity, far removed from its, in retrospect, rather simplistic biology is the framework Jain then uses to analyze her (and by extension, every patient’s) experience with the disease. Because her definition is so expansive, she has the opportunity to extend her analysis far beyond sufferers, doctors, and medical and governmental institutions, and she does so with headstrong ferocity. Her thesis — that cancer has become an integral part of American life culturally and economically — requires such breadth of inquiry. She touches on topics as diverse as pharmaceutical companies being deincentivised to develop and distribute specific (and therefore more effective) cancer drugs, the psychological effects of the reductionist, numerical approach to treatment, and the knowledge and experience gap between doctor and patient. Her source base is broad, consisting of scientific articles, popular news sources, advertisements, statistics, court documents, and more, all supplemented by personal anecdotes and experiences. This would imply integrating multiple perspectives, but none are fleshed out. Although she references many perspectives for her arguments’ sake, one is clearly dominant in her work.

At the risk of sounding reductionist, cancer is a disease; while it has many cultural manifestations and effects that make it unique and important, it is a large claim indeed to assert that cancer is as central to American culture, politics, and economics as Jain does. This is one of the weaknesses of the patients’ perspective; when threatened with a life-altering (and sometimes ending) illness, an individual would see it everywhere. Like Jain herself argues, it is difficult when diagnosed with cancer to remain an individual — sufferers lose their individuality to the disease, and it is difficult to gain it back. They either die or become a “cancer survivor,” and everything, including their perceptions and reasoning, can easily become influenced by their frightening and tragic experiences.

Malignant fails to provide practitioner and institutional perspectives, and as a result, its content is skewed by the vision of a single angle, albeit a powerful one. Jain fails to present why the statistical approach is used, and she leaves out the many success stories the current system has accomplished. While her work is very important — it highlights issues inherent in the way cancer is conceptualized and handled that could garner support for meaningful changes, and it offers a valuable look at the cancer experience from an articulate, thoughtful actor within — it fails to capture broader scientific and theoretical understandings of the disease. Without such an understanding, it is very difficult to explain the current system in a fair light, and paired with Jain’s irreverent commentary, a biased interpretation is the result.

The Wages of Sin

The last book to be included in this survey was authored not by an anthropologist or a historian, but a literary scholar. Peter Lewis Allen wrote The Wages of Sin: Sex and Disease, Past and Present about many diseases; greatly affected by the AIDS epidemic of the 1980s, Allen approached his work differently than most others. His experience with institutional responses to AIDS, and their subsequent effect upon a vulnerable and suffering population, sent him looking for the roots of such phenomena. What he came up with was a consortium of illnesses that had historically been associated with sin, sexual deviance (as was the case with AIDS) being a major component of most eras’ beliefs on immorality. He thus isolated an aspect of society to look at — conceptions of sin — and found examples of diseases with cultural definitions that included a dimension of immorality.

In an attempt to establish a timeline from the Middle Ages — “the cradle of the modern world” — to the AIDS epidemic, Allen chose illnesses that he perceived as exemplary of his theoretical hypothesis from 1000AD to the modern era.[15] A disease would emerge and become associated with vice, and subsequently, those afflicted with it would be treated poorly by medical institutions and practitioners alike. His case studies include lovesickness and leprosy in the Middle Ages, syphilis and the Bubonic Plague in the early modern period, masturbation (or “onanism”) in the nineteenth century, and, of course, AIDS in the twentieth century. By looking at the way that institutions and practitioners characterized the disease and those that carried it, Allen tries to show institutional discrimination based on sexuality, morality, religiosity, and lifestyle. His source base includes medical tracts, theological treatises and sermons, and, especially in the chapters on more recent diseases, personal accounts and government-sponsored pamphlets.

The biggest issue with Allen’s work lies in his approach. Though he is open about his bias, like S. Lochlann Jain, his experiences with socially stigmatized disease colored his interpretive approach to his research. Instead of taking the diseases as the complex and multi-faceted entities they are, Allen focused on a single aspect of their definition — their cause — and even within that narrow framework considered only perceived causes that supported his argument.

Even while writing within a context of patient injustice, Allen’s source base is primarily composed of institutional and practitioners’ perspectives. This is perhaps due to a lack of sources for patients’ experiences, but it presents a methodological issue; how can we understand the hardships that theoretical links between disease causation and morality impart upon the ill when their experiences are not vivified? True, the practices outlined by doctors for the treatment of syphilis sound heinous — mercury, one of the most popular anecdotes for the disease, caused “excessive salivation, loosening of teeth, pain and numbness in the extremities, uremia, renal damage… vomiting, dizziness, convulsions, tremors, liver damage, anorexia, severe diarrhea, and mental deterioration”[16] — but as mentioned in the introduction, if this information comes from doctors, their motivation and biases may have influenced their writings. Without the voices of the oppressed, Allen’s argument is difficult to bring to satisfying fruition.

In a way, the book Allen was trying to write is nearly an impossible endeavor. Diseases cannot be reduced to a single dimension of their complex and intricate social understanding; when a writer does so, he or she is oversimplifying the issue to the point of historical inaccuracy. Yes, sufferers of AIDS certainly experienced very real discrimination as a result of their affliction being associated with sexual deviance, but some doctors and politicians did not share this view. As the case of Ryan White, a child diagnosed with AIDS whose school community attempted to keep him from attending for fear of infection, shows, anxiety about HIV was multifaceted and concerned with more than just homophobia. Although is work is useful in that it highlights major ideological trends in disease conception and association with morality, its value as an example of employing disease as a framework of analysis is notably lackluster.

Conclusion

Diseases are complex entities that require in-depth and multi-faceted approaches to properly understand, but through their complexity, they have amazing capabilities as frameworks of analysis. Because their definitions are so expansive, and because they touch so many aspects of social and cultural experience, they can provide an excellent inroad into issues that might at first seem unrelated. Leslie Reagan demonstrated how they can uncover race and gender issues inherent in medical care and political activism, and Peter Lewis Allen exhibited how they can be used to understand morality and blame. Equally important is the way diseases can provide environments of heightened anxiety that present a society’s prejudices, fears, and motivations in microcosm, ripe for analysis. Warwick Anderson made use of the atmosphere kuru created in order to understand networks of scientific and anthropological exchange, just as Charles Rosenberg utilized epidemics of cholera, and the abundant commentary they bred, to trace changing ideas about disease causation and religiosity. The power of disease for any historian is hard to contest.

In order for a framework of illness to avoid biases, however, it is important for researchers to be inclusive. Acknowledging the complexity of socially constructed definitions of diseases is paramount, and to do so, an author must incorporate more than just a single perspective. Illness is experienced by different players in the game that constitutes dealings with disease in different ways, and a methodology that only employs a single angle, or even does not employ all of them — the patient, the practitioner, and the medical institution with which both are associated — will produce only a piece of a complex and difficult puzzle. Many of the works surveyed here fell into this trap, to the detriment of the integrity of their work. They may have maintained useful arguments and made points worth pursuing, but their narratives were nonetheless incomplete if they did not incorporate the many experiences that make up disease.

 

 

[1] Robert A. Aronowitz, “Lyme Disease: the Social Construction of a New Disease and Its Social Consequences,” The Milbank Quarterly 69, no. 1 (1991): 79.

[2] Peter Lewis Allen, “Syphilis in Early Modern Europe,” in The Wages of Sin: Sex and Disease, Past and Present (Chicago: University of Chicago Press, 2000).

[3] See Leslie J. Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America (Berkeley: University of California Press, 2012) and Keith Wailoo, Dying in the City of Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: University of North Carolina Press, 2001). Although not included in this survey, Wailoo’s work also utilizes disease (in this case, sickle cell anemia) as a framework of analysis.

[4] Charles Rosenberg, “Poverty and the Prevention of Disease” in The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: University of Chicago Press, 1962).

[5] Peter Lewis Allen, The Wages of Sin: Sex and Disease, Past and Present (Chicago: University of Chicago Press, 2000), xvii.

[6] Peter Lewis Allen, The Wages of Sin, xviii.

[7] Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866, 4.

[8] Ibid., 219.

[9] Emphasis added. Leslie J. Reagan, Dangerous Pregnancies (Berkeley: University of California Press, 2012), 2.

[10] Leslie J. Reagan, Dangerous Pregnancies, 3.

[11] Warwick Anderson, The Collectors of Lost Souls: Turning Kuru Scientists into Whitemen (Baltimore: Johns Hopkins University Press, 2008), 5.

[12] Ibid., 202.

[13] S. Lochlann Jain, Malignant: How Cancer Becomes Us (Berkeley: University of California Press, 2013), 2.

[14] Ibid., 4.

[15] Peter Lewis Allen, The Wages of Sin, xix.

[16] Peter Lewis Allen, The Wages of Sin, 55.

Nuclear Energy

Being Nuclear: Africans and the Global Uranium Trade, Gabrielle Hecht

            Gabrielle Hecht’s unconventional approach to a history of the global uranium trade — centered around a traditionally forgotten player, Africa — offers new insight into the effects of the post-World War II technopolitical atmosphere. Hecht introduces the term “nuclearity” to describe the degree of association of various places and things with “nuclear exceptionalism,” a category that placed entities in a position in which they would be regulated according to their perceived risks as nuclear things. The nuclearity of different places and things was renegotiated in various places and times, Hecht argues, often due to changing political and technological climates. The author traces the development of the nuclear market, an action made possible by politically motivated nations’ reclassifying uranium as a marketable commodity not associated with its nuclear qualities in Part I, and goes on in Part II to examine the struggle to assign nuclearity again to African uranium mines in order to ascertain the presence and severity of health issues associated with radon exposure. Notable in her narrative is Hecht’s inclusion of the underpriviledged workers and communities that the fluctuating definition of nuclearity often subjugated to the economic and political interests of those in power.[1]

I was fascinated by Hecht’s work in Part II on nuclearity’s effect on organizations’ and governments’ handling of the occupational health issues of uranium miners. In her narrative, retold through many examples throughout the book, workers and organizations concerned with workers’ health had a very difficult time making the medical consequences of radon exposure visible. One reason for this, Hecht argues, is that the infrastructure required to create knowledge about uranium’s health effects was not present. An association between the work performed by the miners and the (often long-term and delayed) illnesses from which they suffered proved difficult to ascertain with certainty — especially when the economic consequences of such an association were of such importance. I wonder why knowledge created elsewhere — in studies conducted on uranium mines in the United States or France, for instance — was not transferrable. Why should the same study need to be conducted in every individual uranium mine? Could nuclearity, either through its political or economic interpretations, have had an effect on how mobile knowledge about radon exposure was? Technopolitical and economic motivations, it seems, have direct implications for knowledge mobility.

Osiris — Global Power Knowledge: Science and Technology in International Affairs

Osiris’s special issue on “Global Power Knowledge” offers a broader perspective of one of the key issues that underlies Being Nuclear — that of science and technology’s changing relationship with politics after World War II and its importance in understanding international affairs in the Cold War and modern era. Articles, roughly divided into temporal sections, deal with multiple themes. One such topic is the technopolitical race for sovereignty and supremacy; decolonization ushered in a new era where international power hierarchies were based upon scientific and technological adeptness, and nuclear technologies played only a part in this discourse. Another important line of inquiry is the effect state patronage (and thus, at varied extents, state motivations) has had on the kinds of knowledge produced, its mobility between nationalized centers of production, and the institutions and frameworks that sponsored it. The last theme, globalization, underlies articles that discuss the relationship between science and technology’s increasingly important role in politics in the modern era. The rise in significance of NGO’s and their influence on scientific work, collaboration, and funding has changed the technopolitical atmosphere in which researchers conduct studies. While far from exhaustive, this summary offers the main ideas that run through the many more specific articles that make up the collection.

I was taken aback by something after reading Being Nuclear and browsing through Osiris’s “Global Power and Knowledge” special addition: the degree of integration of technology into politics and the many effects this has had. If I had a nickel for every time the term “technopolitical” came up in the readings this week, I would be a very rich woman, and for good reason — it seems that the twentieth century witnessed an unprecedented increase in the integration of scientists, engineers, and their technologies into the political realm. The rise and attempted control of nuclear power sources exemplifies this transition. Hecht’s work discusses how the political implications of nuclear power resonated in many different spheres, and one example she articulates in particular resonated with me. The value of uranium to African countries attempting to solidify their sovereignty was paramount due to the (however well-hidden in the development of the “banal” uranium market) political implications of a nuclear research program in the international community. This had direct ramifications for those working in African uranium mines; the radon particles poisoning workers’ lungs was, although known to some extent, underplayed and understudied. Politics, in this instance, dictated not only what would and would not be scientifically studied in regards to the development of an atomic industry; it harmed an entire group of underprivileged people in a very real way. Technology and politics, I think, are two entities that should be very carefully monitored if allowed to join their power and motivations at all.

This led me into further reflection about something we have discussed many times in class — the line between history and social and political commentary. While I still find “purer” histories more to my intellectual taste, the value of histories that address modern-day implications is difficult to contest. In the case of Being Nuclear, there are still workers subjected to dangerous levels of radiation in uranium mines; how could a researcher not include this in her study? And how could a reader, whether or not the language used by the researcher implies it or not, not feel moved to action by such facts? Perhaps what I am getting at here is that a book does not need to be written politically to have political implications for its readers. If there truly is an injustice at hand, honest research and fact presentation should produce a result in reader activism just as readily as a polemic-ridden commentary on a perceived transgression would.

[1] Sorry for the nineteenth century paragraph, but this book was long, the arguments many, and the subject matter complicated.

Routes of Power

Routes of Power: Energy and Modern America, Christopher F. Jones

            In his study of shifting power regimes in industrializing America, Christopher Jones emphasizes the importance of transportation networks in the formation of an “energy-intensive world.” Jones covers the time period from 1820, when citizens garnered their energy in an organic way (using primarily plants, falling water, and wind, all derivatives of solar energy), through to 1930, when the transition to a mineral-based energy was completed (coal, oil, and electricity covering most of Americans’ energy needs). The effects of such a transition are highlighted and include the proliferation of larger cities with concentrated industrial output, energy’s correlation with cost instead of labor, and communities’ differing degrees of inauguration into the new energy regime with various consequences. In each chapter, the author emphasizes transportation networks — canals, railroads, pipelines, and wires — and their role in creating “landscapes of intensification” that created the demand that would sustain the transformation from an organic to a mineral energy regime.

Both Christopher Jones and David Nye in America as Second Creation discussed the role of the booster in garnering support for the usage of new technologies; these men obviously played a major role in encouraging the usage and the overall proliferation of novel technological feats. I find their presence often in works dealing with medical speculation as well, such as James Harvey Young’s Toadstool Millionaires, which discusses the rise of patent medicines in nineteenth century America. I wonder if there have been any studies of these men; what motivated them, and were they a uniquely nineteenth century phenomenon? They probably maintained a relatively precarious existence, because new technologies harbored grave risks for investors (and those touting their benefits) if a society did not see their value. What about the nineteenth century made these men so visible, and how did they influence the course of American industrialization? Was their participation needed, even inevitable?

I also found it fascinating how influential seemingly unrelated historico-political factors were in the inauguration of certain technologies into common usage. Susan B. Pritchard’s Confluence analyzes how the techno-manipulation of the Rhône was discussed in a nationalistic, conquering language, and how its goals reflected France’s attempts to legitimize itself after a humiliating defeat at the hands of its rivals. Similarly, the way that canals were built in America was influenced by the way that Americans saw themselves at the time; large-scale federal governmental involvement was discouraged at a time when republicanism dominated. Investors, then, and state charters decided the course and language of construction. Technology, both authors’ books discuss, is affected by social and political factors, just as it has effects on both.

Something I found particularly interesting was the way that mass commodification and physical distance between sites of energy production and sites of energy consumption has affected people’s relationship with energy. No longer something that must be earned through hard labor, energy can be purchased; this has changed the way that people use energy. This distance between production and consumption, I think, was a product of industrialization and mass production and can be seen in many other aspects of society. Medical knowledge, for example, has been standardized and delegated to a certain class of people, and most patients do not care to look into the technicalities of their diseases. They leave their lives completely in a doctor’s hands. The distance between the producer of medical knowledge, the doctor, and the consumer, the patient, has increased as the language of disease has become more technical and the technologies of diagnostics more specialized. Before medicine had been commodified and, more importantly, standardized, people played a much more active role in their health decisions. The commodification and standardization of energy consumption has had similar effects; people delegate their energy needs to others to the extent that they know almost nothing about its production. Commodification and standardization, then, create distance between producers and consumers. I wonder what sorts of ramifications this has, and especially what sorts of exploitation has resulted from it.

Vernacular Knowledge

The Crafting of the 10,000 Things: Knowledge and Technology in Seventeenth-Century China, Dagmar Schäfer

            In her analyses of the writings of Song Yingxing (1587-1666?), author Dagmar Schäfer elucidates the intricate and complex systems of knowing in seventeenth-century China. Song was part of a society in which individuals were divided into four major classes: scholars, farmers, merchants, and craftsmen. While Song’s writings reflect these subdivisions (and the social hierarchies in which they were placed), they also defy his society’s unique knowledge classification systems by emphasizing the role of qi in universal harmony and understanding. In a method markedly different from his contemporaries, Song proposed a chaos-defying system based on qi and “natural phenomenon and the production of material objects,” instead of on “moral categories of ‘heaven’” imposed on humanity.[1] Schäfer brilliantly highlights how cultural, political, and societal influences play a role in knowledge production and understanding through her case study analysis of a single, at times abnormal and at times quite typical, lower-ranked Chinese scholar. 

Science in the Everyday World: Why Perspectives from the History of Science Matter, Katherine Pandora and Karen A. Rader

            Science in the Everyday World brings attention to the tendency for scientists and historians of science to discount or altogether ignore the importance of those “outside the temple of science” and in the realm of popular culture in the production and perpetuation of knowledge.[2] To assume that all knowledge is synthesized in the laboratories of professional scientists leaves out the many, equally important actors at play in the lay world. If historians will venture into the realm of popular cultures of science, Pandora and Rader argue, we have to gain “the positive transformation of relations between expert scientific practitioners and nonexpert public science participants.”[3] The authors then illustrate how this type of analysis should be carried out by discussing three examples: historians’ work on the nineteenth-century scientific popular culture, the development of and motivations behind scientific museums, and twentieth century media portrayals of the scientist. By understanding the ways that the scientific community and laypeople communicate with one another, scientists can benefit from historians in a way that will make future conversations far more rewarding.

Pandora and Rader’s piece on popular science reminded me very much of Nancy Tomes’s work, The Gospel of Germs. Tomes appears to use the exact analytical strategies proposed by Pandora and Rader; she attempts to understand the lay American reaction to an awareness of microbial disease-carriers. A marked difference between this approach and the more traditional, top-centered strategy can be located in the source base. Pandora and Rader’s brief discussion on popular representations of scientists in the twentieth century focus on film and television shows, while Tomes uses similar sources that lay outside of the professional realm, including advice books, patent applications, advertisements, and oral histories. While these sources may not always be the most visible, apparent, or traditional, they offer insight into a completely different aspect of scientific culture — one that is equally important to the acquisition and transmission of knowledge.

I find the indirect approach to the historical study of scientific understanding the most fascinating, and arguably the most important. While scientists like to isolate themselves physically and professionally, they are still part of the worldly, human-comprised community. They are not immune to its structure, politics, culture, or ideas, as many proponents of the SSK school would argue. I think, however, that one of the most effective ways of understanding the context in which science is conducted is to study the consumers of science. Their role in the creation of scientific knowledge has been paramount; after all, without public support science (usually) cannot operate. And how science sells or isolates itself from the common people can have major implications for what kind of science is done. Equally interesting and useful is the study of how science has affected the communities for which it operates; how did your average American understand germ theory, and how did this change how they behaved? A question taken up by Tomes, this kind of inquiry can lead the historian to better understand what role science has played in the overall history of humanity, and like Pandora and Rader argue, it can facilitate important modern-day conversations between scientists and common audiences.

[1] Dagmar Schäfer, The Crafting of 10,000 Things, 52.

[2] Katherine Pandora and Karen A. Rader, “Science in the Everyday World,” 350.

[3] Ibid, 354.

Visualization

Visible Empire: Botanical Expeditions & Visual Culture in the Hispanic Enlightenment, Daniela Bleichmar

            Author Daniela Bleichmar bases her study of Hispanic botanical expeditions around the images created during them in order to analyze the place of illustration in the Enlightenment natural philosophical era. Through these images, Bleichmar elucidates the motivations behind their production (to exploit natural colonial resources and make colonial flora “mobile”), their place in and exemplification of the international botanical network, and what they said (and did not say) about the places from whence they came. Bleichmar also takes the opportunity the images provide to discuss and analyze Hispanic colonial changes in the seventeenth- and eighteenth-centuries and the economic motivations for botanizing expeditions. Underlying her entire analysis is an insistence and explanation of the importance of visual epistemologies in Enlightenment science, especially in the Spanish Empire. 

The Image of Objectivity, Lorraine Daston and Peter Galison

            In a survey of atlases of the nineteenth- and early twentieth-centuries, authors Lorraine Daston and Peter Galison trace changing ideas in the scientific community about visual representations of natural phenomena. The predominate methods of representation in the nineteenth-century concerned themselves with being “true to nature.” Experts who put together the atlases were supposed to, with their professional knowledge of a subject, use their judgment to create images that would be representative of natural things. A different view, a mechanical objectivity, began developing mid-century and stressed instead the importance of ridding scientific representations of their human components, or subjectivity. Judgment on the part of even professional scientists was viewed as immoral; professional scientists were expected to refrain from inserting themselves into their objective representations of natural phenomena. This mentality propelled imaging machines to the forefront of representational technology, especially the camera, and encouraged publication in atlases of multiple images of the same thing, so that the burden of representation was transferred to the audience.

The role of visual epistemologies was also addressed in Daniel Margoscy’s Commercial Visions. The standards for anatomical representations — the way that different anatomists vied for various methods of representation as superior — stands in stark contrast to the homogeneity in opinion about the hierarchy of botanical representations. At least as Bleichmar presents it, most naturalists were in agreement that visual representations were better than textual or physical renditions of plants. That being said, the goal of a representative, ideally easily reproducible representation was common to both anatomists and botanists. The goal of classification, such a powerful component of Enlightenment natural philosophy, deemed the standardization of nature necessary.

The role of the artist was addressed in both Visible Empire and The Image of Objectivity, and both works depicted the relationship between artist and scientist as a contentious one in some respects. The implied subjectivity of the artist was a source of tension, as was their propensity for creative license. Scientists felt the need to very literally look over their shoulders as they attempted to conform to the scientists’ particular definition of “objective.” What Galison and Daston and Bleichmar stress, however, is that standards of objectivity were quite subjective themselves. The leaving out of parts of plants, for example, was common practice in colonial Spanish scientific representations of colonial flora. These representations were also selective in that they portrayed only the plant, even simply parts of the plant, and left out their surroundings completely. Additionally, as Daston and Galison highlight, standards for objectivity in representation have changed over time, indicating further their transitory nature. It seems that the very subjectivity scientists were attempting to eliminate from their representations was present nonetheless, inherent in the selectivity scientists imposed upon the subjective artists they employed.