Taking a medical history in childhood illness: Representations of parents in pediatric texts since 1850

Bulletin of the History of Medicine

Volumn 79, Issue 3, 2005, Pages 393-429

  Gillis, Jonathan ^a  

^a CHILDREN S HOSPITAL AT WESTMEAD   (Australia)

Author keywords

Children; Clinical encounter; Medical history taking; Mothers; Parents; Pediatrics

Indexed keywords

EID: 27144452010     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2005.0105     Document Type: Review

References (156)

1. This can be seen as a variant of "medicine from below" in which the clinical encounter is viewed by the physician rather than the patient. See Roy Porter, "The Patient's View: Doing Medical History from Below," Theory & Soc., 1985, 14:175-98.
2. Two technical choices made for this article should be recognized: (1)1 have elected to designate physicians and doctors as "he," which is as it was for the practitioners who lectured and published in this area. (2) The parent has been essentially equated with the mother, who appears to have been the main parent involved in the clinical encounter - or at least the parent described in pediatric texts. The subject of fathers is an important one, which will need separate investigation. See Judith Leavitt, "What Do Men Have to Do with It? Fathers and Mid-Twentieth-Century Childbirth," Bull. Hist. Med., 2003, 77:235-62, for a similar separation of male and female experiences of childbirth.
3. See Sydney Halpern, American Pediatrics: The Social Dynamics of Professionalism, 1880-1980 (Berkeley: University of California Press, 1988);
4. Thomas Cone, History of American Pediatrics (Boston: Little, Brown, 1979);
5. F. Garrison and A. Abt, Abt-Garrison History of Pediatrics (Philadelphia: Saunders, 1965);
6. Roger Cooter, In the Name of the Child: Health and Welfare, 1880-1940 (London: Routledge, 1992);
7. Alexandra Stern and Howard Market, eds., Formative Years: Children's Health in the United States, 1880-2000 (Ann Arbor: University of Michigan Press, 2002).
8. Viviana Zelizer, Pricing the Priceless Child: The Changing Social Value of Children (New York: Basic Books, 1985).
9. See also Alisa Klaus, Every Child a Lion: The Origins of Maternal and Infant Health Policy in the United States and France, 1890-1920 (Ithaca: Cornell University Press, 1993).
10. Anne Digby, Making a Medical Living: Doctors and Patients in the English Market for Medicine (Cambridge: Cambridge University Press, 1994).
11. Samuel Radbill, "Hospitals and Pediatrics, 1776-1976," Bull. Hist. Med., 1979, 53: 286-91.
12. These include Charles West, Lectures on the Diseases of Infancy and Childhood (London: Longman, Brown and Green, 1848), which went through six editions between 1848 and 1874;
13. and John Thomson, Guide to the Clinical Examination and Treatment of Sick Children (Edinburgh: Clay, 1898), four editions between 1898 and 1925.
14. Elizabeth Lomax, Small and Special: The Development of Hospitals for Children in Victorian Britain (London: Wellcome Institute for the History of Medicine, 1996), pp. 169-70.
15. For example, David Condie, Practical Treatise on the Diseases of Children (Philadelphia: Lea and Blanchard, 1844), six editions between 1844 and 1868 (Condie was a Philadelphia physician);
16. Job Lewis Smith, Treatise on the Diseases of Infancy and Childhood (Philadelphia: Lea, 1869), which took over from Condie's textbook.
17. John Keating, ed., Cyclopaedia of the Diseases of Children, Medical and Surgical (Philadelphia: B. Lippincott, 1889-99);
18. Louis Starr, An American Textbook of the Diseases of Children (Philadelphia: Saunders, 1894);
19. Thomas Morgan Rotch, Pediatrics: The Hygienic and Medical Treatment of Children (Philadelphia: J. B. Lippincott, 1896);
20. Luther Emmett Holt, The Diseases of Infancy and Childhood (New York: Appleton, 1897). Holt was professor of pediatrics at the New York College of Physicians and Surgeons, and Rotch held the first chair in pediatrics at Harvard University; both their texts were very successful, with Holt reaching a seventh edition by 1920 and Rotch a fifth edition in the same year. Louis Starr was clinical professor of the diseases of children at the University of Pennsylvania.
21. Most of the discussion here is on the development of pediatrics in the United States as outlined by Halpern, American Pediatrics (n. 3),
22. and Cone, History (n. 3).
23. There was a great deal of interchange between American, British, and Scottish pediatric authors who contributed chapters to each others' texts. The early foundling hospitals were begun in New York: "Virtually every name that was to become prominent in pediatrics in New York City - Abraham Jacobi, Job Lewis Smith, Luther Emmett Holt, John Howland, William P. Northrup, Joseph O'Dwyer - was associated with the medical board of one or more of these institutions" (Peter English, "Pediatrics and the Unwanted Child in History: Foundling Homes, Disease, and the Origins of Foster Care in New York City, 1860-1920," Pediatrics, 1984, 73:699-711, on p. 704).
24. Richard Meckel, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850-1929 (Baltimore: Johns Hopkins University Press, 1990), p. 47.
25. Kathleen Jones, "Sentiment and Science: The Late Nineteenth-Century Paediatrician as Mother's Advisor," J. Soc. Hist., 1983, 17: 79-96, at p. 85.
26. Stanley Reiser, Medicine and the Reign of Technology (Cambridge: Cambridge University Press, 1978).
27. See also Edward Shorter, "The History of the Doctor-Patient Relationship," in Companion Encyclopaedia of the History of Medicine, ed. William Bynum and Roy Porter (London: Routledge, 1993), pp. 783-99.
28. William Cullen, Nosology, or a Systematic Arrangement of Diseases (Edinburgh: Creech, 1800).
29. Lester King, Medical Thinking: A Historical Preface (Princeton: Princeton University Press, 1982), p. 82.
30. See also Roy Porter, "The Rise of Physical Examination," in Medicine and the five Senses, ed. William Bynum and Roy Porter (Cambridge: Cambridge University Press, 1993), pp. 179-98.
31. Richard Hoblyn, A Dictionary of Terms Used in Medicine, 8th ed. (London: Whittaker, 1858), p. 594.
32. Richard Hoblyn, A Dictionary of Terms Used in Medicine, 9th ed. (London: Whittaker, 1868), p. 646.
33. See Digby, Making a Medical Living (n. 5), p. 280.
34. David F. Condie, A Practical Treatise on the Diseases of Children, 2nd ed. (Philadelphia: Lea and Blanchard, 1847), p. 107.
35. Job Smith, Treatise on the Diseases of Infancy and Childhood, 5th ed. (Philadelphia: Lea, 1881), p. 89. This textbook passed through eight editions (1869-96).
36. Goldie Zimmerman, "Essentials in Pediatric Diagnosis," Minnesota Med., 1918, 1: 298-302, at p. 298.
37. C. K. Johnson, "Symptomatology in the Child," Vermont Med., 1918, 3:83-86, at p. 83.
38. Clifford Grulee, "Diagnostics of Disease in Infancy," J. Missouri State Med. Assoc., 1919, 16:366-72, at p. 367.
39. James F. Goodhart, Diseases of Children (London: Churchill, 1885), p. 2.
40. Holt, Diseases of Infancy (n. 10), pp. 31-32.
41. For the significance of Holt's views for the defining of pediatric practice, see Jonathan Gillis, "Bad Habits and Pernicious Results: Thumb Sucking and the Discipline of Late-Nineteenth-Century Paediatrics," Med. Hist., 1996, 40: 55-73.
42. See also Borden Smith Veeder, Pediatric Profiles (St. Louis: Mosby, 1957), pp. 33-60: "The work was a monument, and its importance can scarcely be overestimated. It lifted child illness and care out of chaos and defined and coordinated it and brought it all together as Pediatrics" (p. 54).
43. See Gillis, "Bad Habits" (n. 26).
44. See King, Medical Thinking (n. 16);
45. Lester King, "Signs and Symptoms," JAMA, 1968, 206: 1063-65.
46. Eugène Bouchut, Practical Treatise on the Diseases of Children and Infants at the Breast, including the Hygiene and Physical Education of Young Children [1845], trans. Peter Bird (London: Churchill, 1855), p. 89.
47. Richard Quain's dictionary of 1882 provided the following definition: "Semeiology: A synonym for symptomatology, or the doctrine of the signs and symptoms of disease" (Richard Quain, ed., A Dictionary of Medicine [London: Longmans, Green, 1882], p. 1416).
48. West, Lectures (n. 7), pp. 2-3.
49. James Finlayson quoted in Keating, Cyclopaedia (n. 10), pp. 73-74. This textbook was a four-volume work representing a consensus of leading English-speaking pediatricians (American, British, and Canadian).
50. Isaac Abt, "The History and Examination of the Patient from the Pediatric View-point," J. Michigan State Med. Soc., 1925, 24:580-84, at p. 582.
51. William Atkinson, "Symptomatology in Infants," JAMA, 1883, 1: 268-71, on p. 268.
52. Joseph Brennemann, "Examination of the Child," in Brennemann's Practice of Pediatrics, ed. Irvine McQuarrie (Hagerstown, Md.: Prior, 1947), pp. 1-3.
53. West, Lectures (n. 7), pp. 8-9.
54. The influence and importance of Charles West and his book are highlighted in Garrison and Abt, Abt-Garrison History (n. 3), pp. 89-91:
55. "The book, which Jacobi describes as 'one of the most instructive and eloquent in medical literature'" (p. 91). Charles West established the Children's Hospital in Great Ormond Street, London, in 1852.
56. West, Lectures (n. 7), pp. 8-9.
57. Starr, American Textbook (n. 10), pp. 1-3, quotation on p. 2. This text was contributed to by sixty-three American physicians, including seventeen of the forty-three founding members of the American Pediatric Society.
58. "No American active during the last decade of the nineteenth century and the early years of the twentieth century did more for the advancement of pediatrics in the United States than Henry Koplik" (Veeder, Pediatric Profiles [n. 26], p. 78).
59. Henry Koplik, The Diseases of Infancy and Childhood (New York: Lea and Febiger, 1902), pp. 34-35.
60. Henry Koplik, The Diseases of Infancy and Childhood, Ibid., 3rd ed. (1910), p. 36: "The mother or nurse of the infant or child is the best observer of his various conditions, and the physician should not lightly reject any facts given to him by an anxious mother."
61. Keating, Cyclopaedia (n. 10), pp. 79-80.
62. The Archives of Pediatrics was the first American and first English-language journal entirely devoted to pediatrics. It was published from January 1884 until September 1962.
63. "Abstracts," Arch. Pediatr., 1884, 1: 49-51;
64. Louis Starr, "Chronic Gastro-Intestinal Catarrh in Children," Arch. Pediatr., ibid., pp. 24-33;
65. John Ripley, "Retro-Esophageal Abscess; Tracheotomy; Death from Exhaustion," Arch. Pediatr., ibid., pp. 104-7;
66. Robert Milbank, "A Case of Acquired Syphilis in a Child," Arch. Pediatr., ibid., pp. 161-63.
67. John Keating, "Infant Feeding," Arch. Pediatr., ibid., pp. 88-95, at p. 90.
68. F. Forchheimer, "Rachitis," Arch. Pediatr., ibid., pp. 139-49, at pp. 139-40.
69. Theophilus Parvin, "Diarrhoea in Children," Arch. Pediatr., ibid., pp. 242-46, at pp. 245-46.
70. See Veeder, Pediatric Profiles (n. 26), p. 13: "Abraham Jacobi, the first professor of diseases of children in America, the pioneer of bedside teaching, the first president of the American Pediatric Society . . . has done more than any physician to place pediatrics in America on a firm and lasting basis."
71. For Jacobi's politics, see Russell Viner, "Abraham Jacobi and German Medical Radicalism in Antebellum New York," Bull. Hist. Med., 1998, 72: 434-63. It is of interest to compare Jacobi's attitudes toward mothers with his membership in the Communist League of Karl Marx and Friedrich Engel and his commitment to socialist worker politics.
72. Abraham Jacobi, "Epilepsy," Arch. Pediatr., 1884, 1: 437-46, at p. 441.
73. M. M'Crory, "Peculiarities of Childhood in Diseases," Med. Times, 1904, 32: 202-5, at p. 202.
74. Robert Hutchison, Lectures on Diseases of Children (London: Arnold, 1904), p. 4 (there was no change in the 2nd-9th eds., 1909-44).
75. Alexander Dingwall-Fordyce, Diseases of Children (London: Black, 1916), p. 31.
76. Brennemann, "Examination of the Child" (n. 35), pp. 1-3.
77. Hutchison, Lectures (n. 52), p. 4.
78. Rotch, Pediatrics (n. 10), p. 319;
79. Holt, Diseases of Infancy (n. 10), pp. 31-32.
80. Thomson, Guide (n. 7), p. 45.
81. Markjampolis, "History Taking and Physical Examination of Infants and Children," in Pediatrics, ed. Isaac Abt (Philadelphia: Saunders, 1923), 2: 77-95, quotation on pp. 79-80.
82. Norman B. Capon, "The Examination of Sick Children," in Symptoms and Signs in Clinical Medicine: An Introduction to Medical Diagnosis, ed. Ernest Noble Chamberlain (Bristol: Wright, 1938), pp. 343-67, quotation on p. 343.
83. Waldo E. Nelson, ed., Mitchell-Nelson Textbook of Pediatrics, 4th ed. (Philadelphia: Saunders, 1946), p. 149.
84. Starr, American Textbook (n. 10), p. 3.
85. Keating, Cyclopaedia (n. 10), pp. 79-80.
86. C. G. Slagle, "Diagnosis in Diseases of Infants and Children," JAMA, 1896, 27:831-35, at p. 831.
87. Wilfrid P. H. Sheldon, Diseases of Infancy and Childhood (London: Churchill, 1936), p. 1.
88. Nelson, Mitchell-Nelson Textbook (n. 60), p. 150.
89. West, Lectures (n. 7), p. 8.
90. Rotch, Pediatrics (n. 10), p. 17.
91. Slagle, "Diagnosis" (n. 63), p. 831.
92. Edmund Chesebro, "Diagnosis in Diseases of Infants and Children," Atlantic Med. Weekly, 1897, 8:273-77, at p. 274.
93. Edmund Chesebro, Atlantic Med. Weekly, Ibid., p. 276.
94. Dingwall-Fordyce, Diseases of Children (n. 53), p. 31.
95. Jampolis, "History Taking" (n. 58), p. 85.
96. Brennemann, "Examination of the Child" (n. 35), pp. 1-3, quotation on p. 2.
97. Holt, Diseases of Infancy (n. 10), pp. 31-32.
98. Luther Emmett Holt, The Diseases of Infancy and Childhood, 3rd ed. (New York: Appleton, 1907), p. 32.
99. Luther Emmett Holt, Jr., Rustin McIntosh, and Henry Barnett, Pediatrics, 13th ed.
100. of L. E. Holt, The Diseases of Infancy and Childhood (New York: Appleton-Century-Crofts, 1962), pp. 52-54.
101. Waldo E. Nelson, ed., Textbook of Pediatrics, 7th ed. (Philadelphia: Saunders, 1959), pp. 161-62.
102. Robert A. Hoekelman, ed., Principles of Pediatrics (New York: McGraw-Hill, 1978), p. 25.
103. Nelson, Textbook of Pediatrics (n. 77), p. 165.
104. Frank Oski, ed., Principles and Practice of Pediatrics (Philadelphia: Lippincott, 1990), p. 28.
105. Abraham M. Rudolph, ed., Pediatrics, 17th ed.
106. of L. E. Holt, Diseases of Infancy and Childhood (New York: Appleton-Century-Crofts, 1982), p. 19.
107. Malcolm I. Levene, ed., Jolly's Diseases of Children, 6th ed. (Oxford: Blackwell, 1991), pp. 1-3, quotation on p. 3.
108. See nn. 45-50.
109. Nelson, Textbook of Pediatrics (n. 77), p. 161.
110. Nelson, Textbook of Pediatrics, Ibid., p. 162.5
111. Rudolph, Pediatrics (n. 81), p. 19.
112. Richard E. Behrman, ed., Nelson Textbook of Pediatrics, 14th ed. (Philadelphia: Saunders, 1992), p. 172.
113. Levene, Jolly's Diseases of Children (n. 82), p. 5.
114. Hoekelman, Principles of Pediatrics (n. 78), p. 31.
115. Nelson, Textbook of Pediatrics (n. 77), p. 161.
116. Nelson, Textbook of Pediatrics, Ibid., p. 162.
117. Nelson, Textbook of Pediatrics, p. 162. Ibid.
118. Hoekelman, Principles of Pediatrics (n. 78), p. 25.
119. Behrman, Nelson Textbook (n. 87), p. 172.
120. John Apley, Paediatrics (London: Bailliere Tindall, 1973), p. 46.
121. Nelson, Textbook of Pediatrics (n. 77), p. 166.
122. Nelson, Textbook of Pediatrics, Ibid., p. 165.
123. Nelson, Textbook of Pediatrics, p. 165. Ibid.
124. Levene, Jolly's Diseases of Children (n. 82), pp. 1-2.
125. Richard Behrman, Robert Kliegman, and Ann Arvin, eds., Nelson Textbook of Pediatrics, 15th ed. (Philadelphia: Saunders, 1996), p. 26.
126. See, e.g., Barbara Ehrenreich and Deidre English, For Her Own Good: 150 Years of Experts'Advice to Women (New York: Anchor Books, 1978);
127. Daniel Beekman, The Mechanical Baby: A Popular History of the Theory and Practice of Child Raising (Westport, Conn. : Hill, 1977);
128. Julia Grant, Raising Baby by the Book: The Education of American Mothers (New Haven: Yale University Press, 1998);
129. Rima Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950 (Madison: University of Wisconsin Press, 1987).
130. Rima Apple, "Constructing Mothers: Scientific Motherhood in the Nineteenth and Twentieth Centuries," Soc. Hist. Med., 1995, 8:161-78, at p. 162.
131. Gillis, "Bad Habits" (n. 26), p. 71.
132. Gillis, "Bad Habits" (n. 26), p. 71. Ibid.
133. Paul Starr, The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, 1982), p. 81.
134. See Melvin Levine, Robert Brooks, and Jack Shonkoff, Pediatric Approach to Learning Disorders (New York: Wiley, 1980), pp. 32-33,
135. which cites, as an example, the psychodynamic approach to reading disorders in Nelson's 1954 edition: Waldo Nelson, ed., Mitchell-Nelson Textbook of Pediatrics, 6th ed. (Philadelphia: Saunders, 1954).
136. John Davis, "British Pediatrics," in History of Pediatrics 1850-1950, ed. Buford Nichols, Angel Ballabriga, and Norman Kretchmer (NewYork: Raven Press, 1991), pp. 31-36, at p. 34.
137. Michael Balint, The Doctor, His Patient and The Illness, 2nd ed. (London: Pitman Medical, 1964), p. 32.
138. See also Thomas Osborne, "Mobilizing Psychoanalysis: Michael Balint and the General Practitioners," Soc. Stud. Sci., 1993, 23:175-200.
139. David Musto, "Child Psychiatry: An Historical Perspective," in Child Psychiatry, ed. Albert Solnit, Donald Cohen, and John Schowalter (Philadelphia: Lippincott, 1986), p. 4.
140. Edwards A. Park was president of the American Pediatric Society in 1941-42. He was head of pediatrics at Johns Hopkins from 1926, and "during this period special clinics were established at the Harriet Lane Home by Edwards A. Park" (Cone, History [n. 3], p. 202). There were initially four special clinics, including the psychiatric clinic, headed by Leo Kanner.
141. Edwards Park was the first recipient of the American Pediatric Society's John Howland Award and Medal, and "the presentation was made by Park's longtime friend and colleague, Grover F. Powers" (Harold Faber and Rustin McIntosh, History of the American Pediatric Society, 1887-1965 [NewYork: McGraw-Hill, 1966], p. 239).
142. Leo Kanner, Child Psychiatry (Springfield, 111.: Thomas, 1935).
143. How often fathers were actors in the clinical encounter is another study. Certainly there is an assumption in pediatric texts that the parent is the mother.
144. See Digby, Making a Medical Living (n. 5), p. 283.
145. M. Jeanne Peterson, The Medical Profession in Mid-Victorian London (Berkeley: University of California Press, 1978), p. 129.
146. Kathleen Jones, "Children, Child Guidance and the Case of the Pathological Mother," Sigerist Circ. Newsl., 1998, 14:13-18, at p. 13.
147. See Alison Bashford, Purity and Pollution: Gender, Embodiment and Victorian Medicine (London: Macmillan, 1998), p. 95.
148. See also Jane Lewis, The Politics of Motherhood: Child and Maternal Welfare in England, 1900-1939 (London: Croom Helm, 1980);
149. Jane Lewis idem, Women in England 1870-1950: Sexual Divisions and Social Change (Sussex: Wheatsheaf, 1984).
150. Carroll Smith-Rosenberg and Charles Rosenberg, "The Female Animal: Medical and Biological Views of Woman and Her Role in Nineteenth-Century America," J. Amer. Hist., 1973, 60: 332-56, at p. 334.
151. See also Ornella Moscucci, The Science of Woman: Gynaecology and Gender in England, 1800-1929 (Cambridge: Cambridge University Press, 1990), pp. 36-37, on the physiology of women and social roles.
152. Ludmilla Jordanova, Sexual Visions: Images of Gender in Science and Medicine between the Eighteenth and Twentieth Centuries (Hemel Hempstead: Harvester, 1989), pp. 20-21.
153. Moscucci, Science of Woman (n. 117), p. 4.
154. Ehrenreich and English, For Her Own Good (n. 101), p. 92.
155. On the female patient see also, e.g., Elaine Showalter, The Female Malady: Women, Madness and English Culture, 1830-1910 (London: Virago Press, 1987).
156. Sarah Brotherton, Holly Mulvey, and Karen O'Connor, "Women in Pediatric Practice: Trends and Implications," Pediatr. Ann., 1999, 28:177-83.