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  • 机译 1943年的神经精神病学:纪录片在医学知识传播和英国精神病学专业推广中的作用
    • 作者:Edgar Jones
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2014年第2期
    摘要:In 1943, Basil Wright produced a documentary film about the treatment of servicemen and civilians with psychological disorders at Mill Hill Emergency Medical Service Hospital. Funded by the Ministry of Information, Neuro Psychiatry was shot to convince influential clinicians and policy makers in North America that the British had developed expertise in the management of psychiatric casualties. By emphasizing novel and apparently effective interventions and excluding severe or intractable cases from the film, Wright encouraged an optimistic sense of achievement. Filmed at a time when victory was considered an eventual outcome, the picture presented a health service to which all had access without charge. Children and unemployed women, two groups excluded under the 1911 National Insurance Act, had been required to pay for healthcare in the prewar period and were shown receiving free treatment from the Emergency Medical Service. However, the therapeutic optimism presented in the film proved premature. Most U.K. battle casualties arose in the latter half of the conflict and follow-up studies failed to confirm the positive outcome statistics reported in the film. Aubrey Lewis, clinical director of the hospital, criticized research projects conducted at Mill Hill for a lack of rigor. The cinematographic skills of Wright and director Michael Hankinson, together with their reformist agenda, created a clinical presentation that emphasized achievements without acknowledging the limitations not only of the therapies offered by doctors but also the resources available to a nation at war.
  • 机译 德国战役伤亡:第一次世界大战期间机能性躯体疾病的治疗
    摘要:World War I witnessed the admission of large numbers of German soldiers with neurological symptoms for which there was no obvious organic cause. This posed a considerable challenge for the military and medical authorities and resulted in an active discussion on the etiology and treatment of these disorders. Current historiography is reliant on published physician accounts, and this represents the first study of treatment approaches based on original case notes. We analyzed patient records from two leading departments of academic psychiatry in Germany, those at Berlin and Jena, in conjunction with the contemporaneous medical literature. Treatment, which can be broadly classified into reward and punishment, suggestion, affective shock, cognitive learning, and physiological methods, was developed in the context of the emerging fields of animal learning and neurophysiology. A further innovative feature was the use of quantitative methods to assess outcomes. These measures showed good response rates, though most cured patients were not sent back to battle because of their presumed psychopathic constitution. While some treatments appear unnecessarily harsh from today's perspective and were also criticized by leading psychiatrists of the time, the concentration of effort and involvement of so many senior doctors led to the development of psychotherapeutic methods that were to influence the field of psychiatric therapy for decades to come.
  • 机译 第一夫人阿尔莫纳:1895-99年在皇家免费医院接受玛丽·斯图尔特小姐的任命,职位和调查结果
    • 作者:Lynsey T. Cullen
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2013年第4期
    摘要:This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed “appropriate” received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.
  • 机译 实用的神学与医学伦理:威廉·珀金斯(1558–1602)著作中的合法药物与非法药物
    • 作者:Norman Gevitz
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2013年第2期
    摘要:This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between “lawful” and “unlawful” medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons.
  • 机译 在现代布列塔尼早期扩大妇女的农村医疗工作:圣灵的女儿
    • 作者:Tim McHugh
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2012年第3期
    摘要:During the eighteenth century, orders of nursing sisters took on an expanded role in the rural areas of Brittany. This article explores the impact of religious change on the medical activities of these women. While limits were placed on the medical practice of unlicensed individuals, areas of new opportunity for nuns as charitable practitioners were created by devout nobles throughout the eighteenth century. These nuns provided comprehensive care for the sick poor on their patrons' estates, acting not only as nurses, but also in lieu of physicians, surgeons, and apothecaries. This article argues that the medical knowledge and expertise of these sisters from the nursing orders were highly valued by the elites of early modern Brittany.
  • 机译 科学研究和企业影响力:吸烟,精神疾病和烟草业
    • 作者:Laura Hirshbein
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2012年第3期
    摘要:Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical).
  • 机译 “上级限制”:爱尔兰私人疯人院的社会角色,c。 1820–60
    • 作者:Alice Mauger
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2012年第2期
    摘要:The period 1820–60 marked an era of transition and diversity in Ireland that rapidly transformed the face of Irish society. Inextricably linked with these processes was the expansion of Ireland's private asylum system. This system diverged from its British counterpart both in the socioeconomic cohort it served and in the role it played within the mental health-care system as a whole. The implementation of the 1842 Private Asylums (Ireland) Act, the first legislative measure geared exclusively toward the system, highlighted the growing importance of private care in Ireland as well as providing for the licensing and regulation of these institutions for the first time. To date, historians of Irish medicine have focused almost exclusively on the pauper insane. This article aims to shift this emphasis toward other categories of the Irish insane through exploration of the Irish private asylum system, its growth throughout the period, and the social profile of private patients. I shall also interrogate the trade in lunacy model through exploration of financial considerations, discharge and recovery rates, and conditions of care and argue that while Irish private institutions were a lucrative business venture, the quality of care upheld was apparently high. Finally, I shall argue that Irish private asylums catered primarily for the upper classes and briefly explore alternative provisional measures for other non-pauper sectors of society.
  • 机译 战争神经症和亚瑟·赫斯特(Arthur Hurst):关于精神战伤亡治疗的开创医学电影
    • 作者:Edgar Jones
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2012年第3期
    摘要:From 1917 to 1918, Major Arthur Hurst filmed shell-shocked patients home from the war in France. Funded by the Medical Research Committee, and using Pathé cameramen, he recorded soldiers who suffered from intractable movement disorders as they underwent treatment at the Royal Victoria Hospital in Netley and undertook programs of occupational therapy at Seale Hayne in Devon. As one of the earliest UK medical films, Hurst’s efforts may have drawn inspiration from the official documentary of the Battle of the Somme and films made in 1916 by French Army neurologists. Although initially motivated to make use of a novel medium to illustrate lectures, Hurst was alert to the wider appeal of the motion picture and saw an opportunity to position himself in the postwar medical hierarchy. Some “before treatment” shots were reenacted for the camera. Hurst, like some other shell shock doctors, openly used deception as a therapeutic measure. On the basis that the ends justified the means, they defended this procedure as ethical. Clinicians also took advantage of changes in military regulations to address functional symptoms. Claims made of “cures” in the film and associated publications by Hurst were challenged by other doctors treating shell shock. The absence of follow-up data and evidence from war pension files suggested that Hurst may have overstated the effectiveness of his methods. Nevertheless, the message conveyed in the film that chronic cases could be treated in a single session had a powerful resonance for ambitious or charismatic doctors and was revived in World War II.
  • 机译 十八世纪中叶的英国和法国的听力科学
    摘要:Benjamin Martin, the English natural philosopher, and Claude-Nicolas Le Cat, the French surgeon, both published important work on auditory physiology and function in the mid-eighteenth century. Despite their different backgrounds, there was consensus between the two scholars on key principles of hearing research, most notably the importance of the inner ear in relation to auditory perception. Martin's work (1755 [1763?]) drew directly on the surgical work of Le Cat (1741) to demonstrate the importance of the auditory mechanism in listening processes. Le Cat's interest in the ear, however, came in turn from his interest in surgical anatomy. Martin used Le Cat's elegant designs as a tool for the vivid communication of auditory function to a popular, fee-paying audience. The meeting of two very different minds through intellectual agreement and material transfer demonstrates the way in which principles of hearing science were established in the Enlightenment period.
  • 机译 两次世界大战期间英国生物医学研究中的信任,协议,性别和权力:凯瑟琳·切瓦苏(Kathleen Chevassut)和多发性硬化症的“病菌”
    • 作者:Stephen T. Casper
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2011年第2期
    摘要:In March 1930, reports of the discovery of an organism causative of multiple sclerosis circulated in the British press. At the same time, news of a therapeutically efficacious vaccine also reached the ears of neurologists and patients afflicted with the debilitating degenerative disease. It was soon shown that no organism had been discovered. The events leading up to this ultimately painful episode reveal many of the central problems created when social conventions and a sense of decorum scripted received understanding of good scientific practice rather than actual regulatory frameworks. In the absence of such frameworks, few means were present to censor inappropriate scientific conduct. This story thus provides a window into an emergent world of state-sponsored biomedical research; a world where recrimination, gossip, misogyny, uncertainty, exaggeration, and dreams and delusions of scientific and therapeutic progress were collapsed together.
  • 机译 自治的局限性:贝尔蒙特报告和童年历史
    摘要:This article examines the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research recommendations on children as research subjects in the context of the history of American childhood. The Commission's deliberations took place during the post-World War II period of rapid changes in understandings of childhood and adolescence, brought on in part by school children's highly visible roles as risk-taking protagonists in the polio vaccine trials and the civil rights movement; by the children's rights movement and court decisions granting children and adolescents greater autonomy in divorce cases and in delinquency and mental health hearings, among other rights; and finally by a renewed movement for child protection led by parents of disabled children and by polio survivors themselves. The National Commission's final recommendations emphasized the need for parents to approve, for children above age seven to assent to research, and for children in special care (either medical, psychiatric, or because they were orphans or had committed juvenile crimes) generally to be subjects of research only if there was some direct connection between the reasons for their special care and the objectives of the research. Ultimately, in these recommendations, the National Commission charted a middle ground between the children's rights movement, which advocated enhanced self-determination for children, and the disability rights movement, which urged greater protection for children.
  • 机译 从感性到病理:大约1800年神经音乐观念的起源
    • 作者:JAMES KENNAWAY
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2010年第3期
    摘要:Healing powers have been ascribed to music at least since David’s lyre, but a systematic discourse of pathological music emerged only at the end of the eighteenth century. At that time, concerns about the moral threat posed by music were partly replaced by the idea that it could over-stimulate a vulnerable nervous system, leading to illness, immorality, and even death. During the Enlightenment, the relationship between the nerves and music was more often put in terms of refinement and sensibility than pathology. However, around 1800, this view was challenged by a medical critique of modern culture based on a model of the etiology of disease that saw stimulation as the principal cause of sickness. Music’s belated incorporation into that critique was made possible by a move away from regarding music as an expression of cosmic and social order toward thinking of it as quasi-electrical stimulation, something that was intensified by the political and cultural changes unleashed by the French Revolution. For the next hundred and fifty years, nervousness caused by musical stimulation was often regarded as a fully fledged Zivilisationskrankheit, widely discussed in psychiatry, music criticism, and literature.
  • 机译 莫兹利医院和洛克菲勒基金会:慈善事业对研究和培训的影响
    摘要:Opened in February 1923 to raise the status of academic psychiatry in the UK, the Maudsley Hospital struggled to secure grant income. Without a track record of published research and lacking internationally recognized clinicians, it failed to impress the British Medical Research Council. To challenge leading U.S. and German departments of neuropsychiatry, Edward Mapother, the medical superintendent, looked overseas for investment in an “institute of psychiatry.” Intense lobbying and a modified strategy for research and training designed to meet the Rockefeller Foundation’s prioritization of psychiatry and medical specialization ultimately led to a significant endowment. Alan Gregg and Daniel O’Brien at the Foundation played a pivotal role in re-defining the Maudsley’s programs of research and teaching. Pressure on Mapother to attract funding was matched by that on administrators required to show that their philanthropy had yielded tangible gains in public health. While wealthy charities, like the Rockefeller, often had a vision of the direction that they wished to pull medical science, and they provided much needed income, the impact of their policy agenda was not without drawbacks. Institutions unwilling to embrace a charity’s philosophy were unlikely to secure grants, while those that did might find themselves drawn into less optimal areas.
  • 机译 重塑临床实践历史中的护理位置
    摘要:This work posits how medical history might be conceptualized if nurses and nursing history was used as the analytical lens. Nursing is seen not as a separate part or subsection of medical history, but rather one that is deeply embedded in the relationships and social order of clinical practice. Nursing is an analytical category in and of itself. By approaching nursing as such a category, we enlarge “new notions of historical significance” to encompass personal, political, public, and private activities that constitute medical experiences.
  • 机译 多伦多卫生部的实际行动:1918年的流感和2003年的SARS
    • 作者:Heather MacDougall
    • 刊名:Journal of the History of Medicine and Allied Sciences
    • 2000年第1期
    摘要:This article compares the Toronto Health Department’s role in controlling the 1918 influenza epidemic with its activities during the SARS outbreak in 2003 and concludes that local health departments are the foundation for successful disease containment, provided that there is effective coordination, communication, and capacity. In 1918, Toronto’s MOH Charles Hastings was the acknowledged leader of efforts to contain the disease, care for the sick, and develop an effective vaccine, because neither a federal health department nor an international body like WHO existed. During the SARS outbreak, Hastings’s successor, Sheela Basrur, discovered that nearly a decade of underfunding and new policy foci such as health promotion had left the department vulnerable when faced with a potential epidemic. Lack of cooperation by provincial and federal authorities added further difficulties to the challenge of organizing contact tracing, quarantine, and isolation for suspected and probable cases and providing information and reassurance to the multi-ethnic population. With growing concern about a flu pandemic, the lessons of the past provide a foundation for future communicable disease control activities.

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