Historiography of the Market for Health

Parallel to my research on socio-educational institutions for the deaf, I’m hoping to tie together themes of technological progress, entrepreneurialism and consumerism with the broad and diverse medical community and marketplace—what we can aptly call medical pluralism. There’s been a lot of historical scholarship on the complex dynamics that wove together a diverse group of sellers, consumers, and products, and on spatial dimensions for a “market” for health services. I thought I’d introduce a few key readings and themes on the topics for scholars unfamiliar with the historiography of the medical marketplace and charlataninsm.

Harold Cook’s model, as outlined in The Decline of the Old Medical Regime in Stuart London (1986), speaks of the “medical marketplace” as reference to not just the plurality of healers and the primacy of market forces (often directed by the patient’s needs and desires), but also on the emergence of an abstract concept of economic space that is governed by the process of commercialization. In the brilliant and meticulously book, Cook aims to uncover  “how the physician of seventeenth century London tried to maintain the dignity of learned medicine by exercising the juridical authority of the College of Physicians and how they ultimately failed in the face of deeply felt economic, intellectual, and political changes” (19). By setting the micro-history of College as the central focus of his analysis, Cook provides a glimpse of how various medical practitioners responded and reacted to the large-scale changes in seventeenth-century medicine during the time of the ‘scientific revolution’ (or the ‘seventeenth-century crisis’). While arguing that this “old medical regime”—a group of men who legally dominated medicine and tried to shepherd other practitioners intellectually and politically—faced an unraveling of their powers and legal limitations imposed on them by the House of Lords, Cook also demonstrates how the legal, intellectual, and political conflicts within this regime encouraged, if not was directly responsible for, the emergence of innovations in medical practice outside the ranks of the learned physicians of the College. Barber-surgeons, apothecaries, and unlicensed “irregulars” steadfastly tended to the need of ordinary Londoners, forming what Cook refers to as the “medical marketplace.” As the medical marketplace formed complex interconnections in society and politics, the old medical regime ultimately failed in the face of deeply felt economic, intellectual, and political changes in the beginning of the eighteenth century.

Margaret Pelling as well, raises critical questions about how large segments of the population—the common lot—experienced illness, health, and disease in early modern England. The Common Lot: Sickness, Medical Occupation and the Urban Poor in Early Modern England (1998) focuses mainly from the archives of Norwich and London. Pelling’s essays cluster around three main topics: the urban environment and experiences of illness by the poor, experiences of health and illness of various types of population groups (disabled, old, women), and the occupational diversity of medical practitioners. Pelling makes it clear that sick people “shuttled” among practitioners in search of relief and did not discriminate between various types of practitioners who chose to specialize. While physicians placed a great deal of effort in creating an acceptable social identity, they were still subjected to the opinions and control of the lay and local populations. One of the most significant arguments made by Pelling was her notion that medicine was an occupation, rather than a vocation. For physicians, the diverse character of the medical occupation was often full of pitfalls and undesirable associations, directing attacks against those deemed as ‘quacks,’ while at the same time helping to shape their definitions of what a profession should be.  Pelling provides a tremendous amount of quantitative and qualitative evidence to argue the complex nature of the social and professional world of medicine, and how concepts of illness as perceived by the populations helped to shape the occupational realms of medicine and their applications of treatment.

Historiography on the medical market—and on quackery—reveal that healers were far from restricted to the old-age pyramid of physicians, barber-surgeons, and apothecaries. These works have questioned and/or modified Cook’s model. In The Medical World of Early Modern France (1997), L.W.B. Brockliss and Colin Jones adopt a Braudelian approach in examining the experience of illness and health in early modern France. Dividing their tremendous text into two phases—before and after the plague as an endemic experience—they investigate the various ways in which medicine was adopted and experienced by a culture dominated by political absolutism in the early 17th century, and scientific optimism in the late 17th century. Building upon the existing historiography of the “medical marketplace,” the authors argue that the model of the medical world consists of two parts: (1) the “corporatist core” consisting of the tripartite ensemble of physicians, surgeons and apothecaries in various legally recognized collective; (2) the core is surrounded by the “medical penumbra,” which is composed of different groups and healers who operated within the core despite not having formal training or corporative status (i.e. the “popular practitioners). The model opposes the analytical dyad of elite/poplar medicine, which Brockliss and Jones argue does nothing but to draw battleground lines and is a misreading of the way medical ideas were diffused. Rather, they argue as the lines between the core and the penumbra became increasingly permeable, the sick found access to all sorts of medical practitioners and did not stigmatize those practicing on “Quack Street.” Furthermore, they point out that the core did not despite charlatans because they were economic competitors, but because charlatans represented an affront to moral and social order—they threatened the dominant social and cultural values held by the population. The enlightenment brought a shift in mentalité—what Brockliss and Jones call “valorization of empiricism”—and provided new egalitarian attitudes for viewing practitioners as social useful, particularly in the provincial press. For instance, a physician’s restraint to newer ideas of therapeutics could actually be harmful for the population, especially if there were more effective “empirical” treatments available. Public opinion, shaped by consumerism and “fashions,” also dictated the medical world, directing the popularity of certain practitioners or certain treatments over others.

A different model is presented in David Gentlicore’s Healers and Healing in Early Modern Italy (1998), a work that is essentially a study of medical pluralism: This book is a study of medical pluralism: the diversity of healers and forms of healing in the kingdom of Naples from 1600 to 1800, particularly from the standpoint of the sick people. Like Cook and Pelling, Gentilcore undermines old myths about early modern medicine, particularly the notion that all healers were neatly categorized accordingly to the pyramid of physicians, barber-surgeons, and apothecaries. Instead, Gentilcore argues that this neat division did not apply to Italy as it did in England; not only were physicians in liberal supply, but many of titles and formal structures they held did not always reveal the practices of healing. Instead, Gentilcore advocates a “medical sphere” model, showing how all types of healers and all explanatory models of illness co-existed, overlapped, competed, and contributed to one another. This model consists of three main divisions that all overlapped with each other—popular, ecclesiastical, and medical—and emphasizes overlapping, but not homogeneous healing communities. Medicine in early modern Italy thus was a complex affair involving physicians, surgeons, apothecaries, official state bodies, quacks, charlatans, magic, religion, and astrology; different kinds of professional boundaries were also created (e.g. “popular healing,” “cunning folk,””midwifery”). On the discussion of irregular practitioners—charlatans, quacks, itinerants, mountebanks—Gentilcore argues that they were far from being automatically labeled as tricksters (e.g. as with the Orivetan case). Even official licensing bodies, such as the Protomedicato, did not aim to impose a unified form of medical practice or eliminate the presence of charlatns; defending the distinctness of each type of healer, official bodies rather aimed to regulate the circulation and growth of charlatans and maintaining professional boundaries. Additionally, Gentilcore argues that patients played as much as of a role in constructing medical pluralism as official bodies and economic concerns: patients were as driven towards their choice of healers as much as by their cultural allegiances to a particular set of healers within their communities. The decline of the medical pluralism in 18th century Naples, Gentilcore argues, was the result of the emergence of a “medical consensus” which strove to create two separate healing cultures (“high” and “low”), a reason he alludes to the enlightenment trends of the period.

Gentlicore’s Medical Charlatanism in Early Modern Italy (2006), on the other hand, is a book about charlatans in early modern Italy: how they were represented, how they saw themselves, and how they were placed within their societies. Charlatans were more than “people who appear in the square and sell a few things with entertainment and buffoonery” (2) or curiosities on the fringes of medicine. Instead, Gentilcore defines “charlatan” as a definable identity—less than a term of abuse and more like a generic, bureaucratic label identifying a category of healer that participated in a trade or occupation. Taking upon an empathetic view of charlatans, Gentilcore argues that they offered health care to an extraordinary wide sector of the population, arguably even wider than physicians. He makes that the multi-faceted nature of Italian charlatanry was also motivated by economic concerns; needing to set themselves apart in an already overcrowded medical marketplace, charlatans often used spectacle and performance to draw attention to their goods and services—but, Gentilcore warns us, we should not use these theatrics as a reason to dismiss the charlatan. Furthermore, Gentilcore questions why the Protomedicato licensed charlatans or tolerated their “behavior,” concluding that the authorities aimed to regulate, rather than dismiss, the variety of healers. In presenting a revisionist correction of the negative role of the charlatan, Gentilcore also emphasizes that charlatans often used the same pharmaceutical ingredients in their treatments, a feature that limited the role of the authorities, who could not prohibit the sale of officially approved medicine. Charlatans, he concludes, also portrayed an important social function by providing a demand within the medical marketplace—e.g. cheaper treatment options, more accessible treatment, etc.—that were limited to patients being treated by “regular” practitioners.

Speaking of quacks and charlatans, Roy Porter’s seminal social history of proprietary medicine and quackery was first published in 1989 as Health for Sale: Quackery in England 1650-1850. In a new edition re-titled as Quacks: Fakers and Charlatans in Medicine (2003), Porter acknowledges that there has been little work published on British quack medicine in the long eighteenth century and that there was a need for a more precise history of quackery apart from its categorical opposition to a  more scientific correct ‘regular’ medicine.  Upon evaluating the changing status and identity of those who were labeled as quacks, Porter makes it clear that his definition of “quack” will not be a timeless, moralizing definition, but rather a historic one that evaluates the behavioral characteristics of certain medical operators; he also avoids any absolute, Platonic, or essential meaning for the application of the term, but takes quacks as ‘the broad spectrum of those operators who were typically pilloried as such.’ Instead of conveying blame or praise, Porter evaluates the varieties of practitioners who peddled quack medicine, contending to Margaret Pelling’s notion that medicine was an occupation and not a vocation. In addition to providing a comprehensive overview of the various ‘types’ of quack medicine, Porter also evaluates the history of medicine as a profession, looking at how market forces, the cash nexus, advertising, and print cultures played a significant role in constructing the medical marketplace.

Anne Digby’s Making a Medical Living: Doctors and Patients in the English Market for Medicine, 1720-1911 (1994) examines the market for medical in 19th century England, examining the interactions between doctors and patients at a time when self-dosing was prevalent. Emphasizing the neglected field of the economic history of medicine, Digby argues doctors’ entrepreneurial activities and their working lives helped to shape English medicine into a distinctive pattern of general and specialist practice. She aims to look at the longer-term dynamics of economic change for practitioners and patients starting from the inception of the first voluntary hospital in 1720 to the National Insurance act of 1911. With much qualitative and quantitative data, Digby examines all aspects of the economic perspective of medicine, from the incomes doctors generated, to patients’ ability to pay for medical goods and services, to the competition for patients and the lack of legislative medical monopoly, and how doctors showed marked commercial flair and versatility in their attempts to expand the medical market. She also provides rich insight into the changing relations between the urban poor and medicine, especially in outlining why and how quacks were more attractive to patients in terms of cheaper costs (e.g. nostrums were popular for their quick and economic means of self-help). Digby also makes the point that the growth of a secular and consumer society that viewed health as a commodity provided a dynamic to sustain and encourage a vigorous commercialism in the medical marketplace; this not only allowed charlatans and quacks to flourish, but also encouraged professionalization as a drive towards a particular ideal or self image that practitioners desired to construct (26). Although concern about quackery waxed and waned accordingly to the state of the medical market, by the 19th century, growing pressure from regular practitioners to create an exclusive medical profession became insufficiently powerful and aimed to create a monopoly for the College of Physicians. Thus, control of the medical marketplace by practitioners became crucial in the process of medicalization as spas, dispensaries, medical charities, and voluntary hospitals became essential to English society.

Colin Jones’ article, “The Great Chain of Buying: Medical Advertisement, the Bourgeois Public Sphere, and the Origins of the French Revolution” (The American Historical Review vol.101 (1996): 13-40)is my absolute favourite essay ever; I read it every time I’m in need of some inspiration. The Great Chain of Buying (a pun on Arthur Lovejoy’s The Great Chain of Being) is a horizontal concept grounded in human sociability and exchange and posits an open and relatively egalitarian social organization undergirding a commercial society. The article aims to build a historiographical consensus intersecting three areas: the economic origins of the French Revolution, the medical profession, and the provincial press. Jones also attempts to restore credibility to a historical approach emphasizing an economized version of capitalism, particularly Habermas’ bourgeois public sphere; it is from this sphere, Jones argues, in which political and revolutionary actions emerges. Jones focuses his historical examination to the archives of the Affiches, the provincial newspapers of France that specialized in advertising while still carrying news and commentary. According to Jones, the Affiches confirm the presence of Habermas’ public sphere and the role of the public in constructing an ideology based on public opinion: as the Affiches were directed to merchants, traders, businessmen and the like, not only was the public sphere bourgeois, but since the editors wouldn’t publish anything to offend their readers, there also existed an ideology implicit in the press viewed as “public opinion.” Furthermore, Jones argues that the Affiches also contained a particular ideology implicit in their advertisement, that is, the notion that commerce would lead to a higher level of civilization and a greater degree of human happiness. Jones analyzes this point by focusing on medical advertisements in the Affiches, arguing that they are relevant for three reasons: 1) advertisements for medical products and services provide historical evidence for a growing medical entrepreneurialism; 2) medical advertisements reflect the growing demand for medical goods and services as well as a growing consumer base; 3) preoccupation with health and the body also had important political implications (e.g. health of the body = health of the nation). As complex as Jones’ argument is, his primary goal in emphasizing the role of the bourgeoisie in participating in the political and social fervor of the nation is important for constructing a historical examination of the lives and thoughts of a large section of the population.

Finally, Mark S.R. Jenner and Patrick Wallis’s Medicine and the Market in England and its Colonies, c.1450-1850 (2007)seeks to undertake a critical examination of the term “medical marketplace” and unpack its various ambiguous meanings. Broadly focusing on the nature of the medical provision and its economic, institutional, cultural and political contexts, this work presents a series of essays that evaluate the scale, scope, and boundaries of the internal dynamics of the market for medicine. Some of the key questions addressed are: what emergences in the medical marketplace? Is the term “medical marketplace” in due of a revision, as Margaret Pelling has argued? Is medicine to be viewed as a market or an economy of health care (and is there a difference)? How do we use a model of the marketplace to historicize and analyze the structure of therapeutic practice and its complex internal and external dynamics? Should historians shift their thinking from an abstract and generalized concept as “medical marketplace” towards a more focused concept of medical goods and services?

Although each essay in the anthology holds its own merit, Michael Brown’s “Medicine, Quackery and the Free Market: The ‘War’ against Morison’s Pills and the Construction of the Medical Profession, c.1830-c.1850” best closely relates to my own research interests. Making the point that while the 18th century has been characterized by a fluidity and plurality of knowledge and practice as well as a cultural of commercial individualism, Brown notes that the 19th century rather saw a hardening of boundaries and the elaboration of more antagonistic cultures within health care (239). He accounts for this shift by building upon Roy Porter’s explanation of the two factors governing the 19th century: the emergence of medical professionalization and medical reform. Within this historiographical context, Brown sets out to explore the mechanisms of the transformation of the mid-19th century English medical marketplace and evaluate how the anti-quackery campaigns of the 1830s and 1840s sought to radically restructure the commercial states of medicine and its relationship to the public (240); he does so by examining the (ideological) “war” against Morison’s Pills, which was a part of a wider attempt to establish the social, legal, and intellectual authority of “orthodox” medicine. He also emphasizes in this paper that the movement for medical reform is essential for understanding the changing perceptions of “quackery” within the 19th century.

There’s lots more scholarship on the topic, more than I can ever write in a blog post, but I hope this is a good beginning  for those interested.

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Histories of Deaf Histories

One of the agendas of my dissertation is to build a steady bridge between scholarship from the history of medicine and scholarship from Deaf and Disability Studies. Granted, as part of my education at IHPST, my research has been lopsided, for I’ve concentrated more on the history of medicine and technologies (especially relating to medical professionalism and quackery) and not so much on Deaf Culture. That’s why I’m so excited to be here at Leeds, emerging myself into a different and unfamiliar scholarship in the hopes of writing a remarkably interdisciplinary dissertation. I’ll have a report from the conference once it’s finished.

On the top of histories of Deaf histories, Lennard Davis has emphasized the deaf person has historically served as an icon for complex intersections of subject, class, and the body.[1] This construction and awareness of the connection to language relied on deafness becoming visible for the first time as an articulation in a set of practices. According to Davis, prior to the mid-seventeenth century, the deaf were rarely constructed as a group; while we may come across a historical record of a deaf individual, he points out that there is no significant discourse constructed on deafness. “The reason for this discursive nonexistence,” he explains,

is that, then as now, most deaf people were born to hearing families, and were therefore isolated in their deafness. Without a sense of group solidarity and without a social category of disability, they were mainly seen as isolated deviations of the norm, as we might now consider, for example, people who are missing an arm. For these deaf, there were no schools, no teachers, no discourse, in effect, no deafness.[2]

Davis continues, somewhat ambiguously, to explain that though deafness did not exist, authors who wrote on deafness did so within a set of practices whereby deafness could be evaluated. In short, deafness and mutism became tied with theories of language and intellect, evaluated and adopted into pedagogical efforts to instruct and educate the deaf.

This stance is interesting for it suggests that marganlized groups themselves have a history that is culturally and socially constructed (which other historians of deformity, insanity, etc., have already discussed). Margaret Winzer also notes that attitudes towards the deaf in the eighteenth and nineteenth centuries were based on defining economic and social conditions; the changing social climate—particularly in France—were thus manifested in the formation of schooling and general attitudes about education towards the deaf. She argues that while the educators recognized the importance of deaf education, the plight of the deaf as a group drew meager public attention, but this does not mean that deafness did not exist as a discourse.[3]

However, the experiences of the deaf were not only closely tied with pedagogical and philosophical examinations, but also with charitable influences as well as medical prospects. While the works of most historians of Deaf Histories have examined the tensions between the deaf body in related to the social body (Winzer, Padden & Humphries), particularly in terms of sign language and communication, others have focused on the concept of deafness as a cultural construction as well as a physical phenomenon (Baynton, Branson & Miller, Davis). These authors argue that as social and medical treatments for deafness became a subject of discourse, deafness thus became “visible” and the body of the deaf individual became a site of Foucaultdian power and social management. Branson and Miller argue that deafness was not merely a condition but a site for social transformation, which became firmly identified with “progress.”[4] In transforming the deaf from a site of philosophical and pedagogical experiments towards a site of the pathological, the deaf became “a measure of humanity’s control over its own destiny, a measure of the power of the scientific method.”[5] The deaf, to put it simply, became the mark of the triumph of medicine, as treatments of the deaf body revealing of the power and control of physicians and surgeons.


NOTES

[2] Davis, Enforcing Normalcy, 51.

[3] Margaret Winzer, The History of Special Education .

[4] Branson and Miller, Damned for their Difference, 88.

[5] Branson and Miller, Damned for their Difference, 88.

Monday Series: Objects of Philosophical Discourse: Deafness and Language in the 1600s

Welcome to yet another edition of this blog’s Monday Series. This series examines how philosophical interest in universal language amongst the early members of the Royal Society of London shaped both philosophical and social perceptions of deafness during the seventeenth century.

 

INTRODUCTION

The seventeenth century saw a tremendous surge in British publications examining deafness in relation to theories about language, speech, and gestures. Among others, John Wallis’ De loquela (1653), George Delgarno’s Art of Communication (1680), and William Holder’s Elements of Speech (1699), actively probed to unlock the mysteries of language and human understanding by recruiting deaf individuals as objects of study for their philosophical and pedagogical aims. These works emerged from the intellectual background of seventeenth century linguistics to project philosophically constructed languages in order to replace arbitrary and conventional ones by proposing a need for a universal character or language understood by all.[1] Language, considered to be the condition for the transmission of empirical knowledge, was believed to be inseparable from speech; in separating the two, philosophers counteracted the deep-seated conviction that the muted deaf were incapable of reason or education.

This series examines how philosophical interest in language amongst the early members of the Royal Society of London shaped both philosophical and social perceptions of deafness by building upon Francis Bacon’s (1561-1626) arguments for a universal language. Inspired by Chinese sinographs, Bacon drew attention to the possibility of representing things by “real characters” instead of sounds, arguing that words could only imperfectly express things. The existence of real characters demonstrated that the order between writing and speaking could be reversed, effectively fostering an effective form of communication that would solve the problem of language diversity.[2] Bacon’s De Augmentis Scientiarum (1632), which explores his ideas on communication, became the bedrock whereby theories on universal language flourished during the seventeenth century. The Baconian requirement of basing science on observation and induction led to a three-fold relationship between language, ideas and knowledge.[3] For instance, John Wilkins (1614-1672), who would become the Royal Society’s first secretary, presented ideas on a universal language that would be constructed to better reveal philosophical truth about nature. Since it was believed that language commonly expressed notions about material reality, a growing concern about the misrepresentation of nature also fuelled the growth of philosophical discourse for a universal language. In short, a proper universal and philosophical language was required in an age that favoured empiricism and experimentalism.

Plate from Bulwer's Chirologia, or the Natvrall Langvage of the Hand

Bacon’s ideas also influenced new philosophical discourses on gestures and communication, evoking new educational enterprises for deaf-mutes. John Bulwer (1606-1656) in his Chirologia, or the Natvrall Langvage of the Hand (1644), for instance, drew upon Bacon’s notion that gesture serves as an effective means of communication between people with different vernacular tongues: “It speakes all languages and as an universall character of Reason, is generally understood and knowne by all Nations, among the formal differences of their Tongue.”[4] The idea that the deaf could communicate without speech revoked the Aristotelian imperatives about the divine origins of speech—Those born deaf are in all cases dumb; they can make vocal noises but they cannot speak[5]—and revaluated the meaning of language. Wilkins thought it was miserable for a rational soul to be denied expression of its cogitations and argued discourse by gestures signified that language was the symbol of ideas evolved to fit social needs.[6] The mathematician John Wallis (1616-1703), on the other hand, disregarded lip-reading as implausible for deaf persons and sparingly used fingerspelling in his instruction. From the Society’s early experiments on acoustics and the propagation of sound, Wallis argued the deaf could be taught to hear sounds and effectively learn to speak. However, he indicated that speech could only successful after a thorough understanding of characters, which in turn could be made possible by a universal language.

In the hands of these philosophers, the deaf, who were long subjected to and defined by myth and superstition, were constructed as the gateway whereby philosophers could invoke new theories about language and its relation to ideas. Schemes and proposals for a universal language provided means whereby instructors could teach their deaf pupils a way to comprehend the natural world around them. Wallis, in particular, was concerned his pupils not taught to articulate without knowing the meanings of the words; without comprehension, he argued the deaf would be no better than parrots. As this series shall show, these philosophical and educational enterprises exemplified by Wallis’ De loquela provided a new epistemological interest that tied together universal language schemes and the emphasis on knowledge with the education and instruction of deaf-mutes.

NOTES


[1] The 1970s and 1980s saw a remarkable increase in scholarship on seventeenth century language projects. Some of these authoritative sources include Charles F. Mullet’s ” ‘An Arte to Make the Dumbe to Speake, the Deafe to Heare’: A Seventeenth-Century Goal,” Journal of the History of Medicine and Allied Sciences vol.26.2 (April 1971): 123-149, Vivien Salmon’s The Works of Francis Lodwick (London: Longman Books, 1970), James Knowlson’s Universal Language Schemes in England and France 1600-1800 (Toronto: University of Toronto Press, 1975), Mary M. Slaughter, Universal Languages and Scientific Taxonomy in the Seventeenth Century (Cambridge: Cambridge University Press, 1982), and Andrew Large, The Artificial Language Movement (Oxford: Basil Blackwell Ltd., 1985). Recent scholarship has delved upon these works, probing the various language projects that emerged during the seventeenth century, particularly the ties it had with the Royal Society of London, the progresses made in algebraic formulas, as well as new voyages of discoveries that exposed Europeans to various indigenous languages. Some of these works are credited in other footnotes in this paper.

[2] Jaap Matt, Philosophical Languages in the Seventeenth Century: Dalgarno, Wilkins, Leibniz (Dordrecht & Boston: Kluwer Academic Publishers, 2004), p.19.

[3] Noga Arikha, “Deafness, Ideas and the Language of Thought in the Late 1600s,” British Journal for the History of Philosophy vol. 13.2 (2005), p.235.

[4] John Bulwer, Chirologia: or the Natural Language of the Hand (London: Printed by Thomas Harper, 1644, p.16.

[5] Aristotle, De Historia Animalium IV, 9.

[6] Charles F. Mullett, “ ‘An Arte to Make the Dumbe to Speake, the Deafe to Hear’: A Seventeenth-Century Goal,” Journal of the History of Medicine and Allied Sciences vol.26.2 (April 1971), p.130.


 

Monday Series: “In the Guise of a Friend” V

Conclusions: A Debt to Alexander the Aggressor?

The deaf community was never at ease with Bell’s eugenics attempts for normalization. When the ABA’s Committee on Eugenics drafted a bill limiting marriage between “undesirables,” the deaf fought back. At his presidential address to the National Association of the Deaf, George Veditz declared that “[i]t is evident that the one person upon whom we must cast the odium of having hated the deaf into this category is Dr. Bell, whom his wealth has rendered the most powerful, and his hobby-ridding propensity the most subtle, because he comes in the guise of a friend.”[1] Yet as John Tabak points out, it is important to acknowledge that the history of the deaf relationship with eugenics is extremely complicated. While many writers describe the deaf as staunch opponents to the eugenics movement, Tabak argues that deaf organizations, especially the NAD, did not oppose eugenics in principle. The NAD was often supportive of arguments for restricting the reproductive rights of the “degenerates,” but their “objections to eugenics arose when [they] found the Deaf included with those same classes. The Deaf, [they] argued, were different.”[2] What the NAD did object to was the paternalistic inclinations from hearing men in influential positions.

Even Bell recognized the differences. He assumed by educating the deaf of the consequences of deaf intermarriages and promoting scientific validation for oralism, he could aggressively protect the deaf community from the same fate that befell other social groups targeted by eugenicists. Eugenics gave Bell a powerful tool for persuading the deaf towards normalization. The deaf were different because they could normalize, and thus, they should normalize. While Bell underestimated the deaf community’s devotion to their own culture, he also failed to grasp that the deaf would intermarry whether or not they used sign language or spoke English. Additionally, as Harlan Lane points out, eugenics measures such as sterilization, social diffusion, or even legislation on marriages would be ineffective, since due to the unpredictable nature of hereditary deafness, the number of deaf children would not seriously decline.[3]

Bell’s work on eugenics and oralism demonstrates how important it is to understand the complex relationship between scientific research and social policy. The potent forces of an ideologically-driven science are powerful enough to drastically influence social attitudes towards a social group, especially a marginalized one. Whether historians of deaf history or historians of eugenics view Bell’s role in the eugenics movement as an active or passive one, Bell nevertheless played a significant role in shaping both the social perception of deafness and the need for normalization within the deaf community. Yet Bell’s arguments on deaf intermarriage was shaped largely in response to the construction of deaf people, and his views adeptly transformed as from his nineteenth century fears about a “deaf variety,” to his twentieth century scientific inclination for normalizing the deaf through oralism and integration. Bell may have neverthless shielded the deaf from the extreme measures of negative eugenics, but he did so in a way that urged for the dissemination of the deaf community; for this, he was vilified.


[1] Veditz, quoted in Lane, “A Chronology of the Repression of Sign Language,” p.150.

[2] J. Tabak, Significant Gestures: A History of American Sign Language, (Greenwood Publishing Group, 2006), p.84.

[3] Lane, “Do Deaf People have a Disability?” p.287.

 

Monday Series: “In the Guise of a Friend” IV

Regulation not Legislation: Avoiding “14 Million Sterilized”

Robert Bruce states that as “a student of heredity, Bell could not resist moving beyond statistics to experimentation.”[1] Sheep breeding and heredity experiments on white cats fuelled Bell’s wistful ambition to be an active, publishing and professional scientist. Word of Bell’s breeding experiments eventually reached Charles Benedict Davenport, spokesman of American eugenics and its spiritual head, and the two men engaged in lengthy correspondence. By merging Galtonian eugenics with Mendelian heredity, the new American eugenics under Davenport’s leadership focused as “the science of the improvement of the human race by better breeding”[2] and gave an institutional base for the movement with the establishment of the Carnegie Institution’s Station for the Study of Experimental Evolution (SEE), and the Eugenics Record Office (ERO) at Cold Spring Harbour in Long Island, New York. These research bodies sought to apply scientific breakthroughs in heredity and eugenics to human affairs in order to purify the American population. Layers of scientific veneer provided prestige to the movement as the most brilliant minds o the country were recruited into the movement: Harry Hamilton Laughlin, David Starr Jordan (1861-1961), Vernon Kellogg (1867-1937), among others were all active participants.

As well, the American Breeders Association (ABA) Committee on Eugenics served as the nucleus for the ERO, and guided the direction of the movement. The ABA Committee and the ERO represented a virtual “interlocking directorate” of American eugenics, and their leadership in a variety of associations, institutions, and committees would continue to lead organized American eugenics well into the 1930s.[3] With Davenport’s connections, Bell obtained sole autonomy to manage the American Breeders’ Association Subcommittee on Hereditary Deaf-Mutism and the ERO’s Committee on Hereditary Deafness.[4] Additionally, Bell served as Chairman of the Scientific Board of Advisors to the ERO from 1912 to 1917.[5] However, as early as 1915, Bell betrayed some uneasiness about what he called “our eugenic cranks.”[6] While Davenport and the other eugenicists focused their research on the implications of eugenics findings for social policy, Bell’s ideas on heredity and eugenics remained consistently positive.

Opposing any scientific interference with the marriages of “undesirables,” Bell denied that such marriages could significantly affect the quality of the human race, a stark contrast to his earlier anxieties of the threat of a “deaf variety.” Bell the eugenicist during the twentieth century was more interested in the science of heredity than racial ideology, though he still continued to emphasize the importance of education, writing that “individuals have power to improve the race, but not the knowledge of what to do.”[7] By disseminating knowledge about heredity and the consequences of ill-chosen marriages, bell believed eugenics could meet its goal for improving the American population. Accordingly, for Bell, the goal of eugenics was not to “eliminate” the likelihood of hereditary deafness along with other “undesirables,” but rather “meant scientific research and discovery, the dissemination of which might encourage those with ‘desirable’ heredity to marry one another for the sake of their own posterity as well as the improvement of the human race” (emphasis mine).[8]

Bell's letter to Davenport (from the Eugenics Archive)

Turning to eugenics to provide a scientific boost for oralism, Bell eventually realized that his personal views on eugenics were in direct opposition with the direction Davenport and Hamilton sought out for the movement. By enforcing his authority on matters of hereditary deafness, Bell also hoped to influence the eugenicists’ focus on “undesirable traits,” by proving that positive alternatives could produce better outcomes for regulating the American population. Greenwald asserts that Bell’s authority prevented practitioners of negative eugenics to interfere with his work, and in doing so, Bell protected the deaf community from the full force of negative eugenic measures.[9] Yet the confluence of Bell’s beliefs was limited in light of the tremendous popularity and speed of growth of the eugenics movement. In a letter to Davenport discussing the role of the Board of Scientific Advisors to the ERO, Bell writes:

The appropriations approved at the first meeting of the Board related exclusively to undesirable characteristics…—cacogenics not eugenicial: Why not vary a little from this programme and investigate the inheritance of some desirable characteristics…It is the fostering of desirable characteristics that will advance the race; whereas the cutting off of our undesirable characteristics simply prevents deterioration.[10]

Like Galton before him, Bell was a firm believer on the proliferation of desirable traits and spent much of his years as Chairman for the Board trying to promote positive eugenics.

As an active participant in the eugenics movement, Bell also constructed a new twentieth century perspective of the deaf that disregarded the notion of deafness as a disability. Whether it was from his observations of the “feeble-minded,” the “criminals,” or other “undesirables,” Bell did not contend that the deaf fell into the same category and could thus be exempt from the same eugenics measures.[11] The deaf were different he insisted, because they had the tools necessary for normalization—oralism—and could thus be educated to avoid contributing to the degeneration of the human race. Jan Branson and Don Miller assert that eugenic measures imposed upon the deaf and other “undesirables” were related in part, to the social construction of deaf people as disabled. Eugenics was a prime ideological force constructing deafness as a medical pathology, but the attitudes and demands from the movement did contribute significantly to how scientists viewed the “unfit.” Building upon Charles Rosenberg’s argument that social attitudes can directly influence the direction of (social) science,[12] it is likely that Bell’s experiences with the eugenics movement and his intimate relationship with the deaf community turned him away from popularized perceptions of the deaf. In doing so, Bell not only shaped, but also deconstructed the notion of deafness as a disability by insisting their “defect” could be “corrected” through normalization.  His feeling of social responsibility and paternalistic stance towards the deaf community also contributed to his need to reinforce a certain conceptualization of the deaf apart from the eugenicists’ classification of “undesirables.” Bell eventually discovered his insistence for positive eugenics could only go so far to deter the ambitions of negative eugenicists.

In late September of 1915, the Hearst syndicate newspapers screamed “14 million to be sterilized” all throughout the country. Already queasy about Davenport’s direction and obsession with defectives, Bell reacted at once, contacting Cold Spring Harbour for some reassurance. Davenport reassured Bell that he would prevent others from believing such a “sensational fake article.”[13] Reminded of his experiences with media misquotes, Bell was hesitantly comforted, and wrote back, “Your note…is a great relief to me, as I was naturally disturbed over the newspaper notices—even though I didn’t believe them.”[14] Yet articles criticizing both the research direction of the ERO and individual eugenicists nevertheless persisted, and by April 1916, Bell had had enough of the public backlash. He sent his resignation to Davenport: “I believe I have now served for three years as chairman. I would very much be obliged if you would kindly present my resignation on the Board and say that it would gratify me very much to have some new member now appointed to the position.”[15] As Black explains the situation, Davenport was shaken up with Bell’s resignation, and persuaded Bell to stay until the end of 1916. Bell reluctantly agreed, Black tells us, “but his connection to the movement was now permanently frayed.”[16] Bell chaired his last meeting for the Board on December 15; after the meeting, Bell severed his association with the movement in a letter to Davenport: “I will no longer be associated with yourself and the other directors. With best wishes for the continuance of the work, and kind regards.”[17]

NOTES:


[1] Bruce, Bell, p.415.

[2] C.B. Davenport, Heredity in Relation to Eugenics (London: Williams & Norgate, 1911), p.1.

[3]S. Selden, Inheriting Shame; The Story of Eugenics and Racism in America (New York & London: Teachers College Press, 1999).

[4] The ABA’s Committee on Eugenics categorized the “socially unfit” into ten subcommittees dealing with a pertinent issue requiring qualified scientific expertise. The ten committees were the Committees on (1) Heredity of Feeblemindness, (2) Heredity of Insanity, (3) Heredity of Epilepsy, (4) Heredity of Criminality, (5) Heredity of Deafmutism, (6), Heredity of Eye Defects, (7) Sterilization and Other Means of Eliminating Defective Germ-Plasm, (8), Genealogy, (9) Inheritance of Mental Traits, and (10) Immigration.

[5] The board also included William H. Welch (vice-chairman), Irving Fisher, Lewellys F. Barker, Thomas Hunt Morgan, and E.E. Southard.

[6] Bruce, Bell, p.419.

[7] Quoted in Haller, Eugenics, p.81.

[8] Quoted in Selden, Inheriting Shame, p.1.

[9] Greenwald, “The Real ‘Toll’ of A.G. Bell,” p.38.

[10] A.G. Bell, “Letter to Charles Davenport about Eugenics Record Office” (December 27, 1912). American Philosophical Society, Dav, B:D27., Harriman, Mrs. E.H.

[11] Bruce writes: “Bell did yield to the assumption, which all those around him took as axiomatic, that ethnic groups somehow differed inherently in temperament and intelligence, as well as in superficial physical characteristics. But he considered such presumed differences irrelevant to the inheritance of deafness, which was his chief concern. And to the end of his life he escaped the fatal delusion of more and more eugenists that they knew just what those supposed ethnic differences were, quite without benefit of scientific study, and could sort them out as “desirable” or “undesirable.” Bell never singled out any specific ethnic group as “undesirable,” though it was commonplace in his day for self-styled eugenicists to stigmatize the Italians, Jews, Slavs, and others. In his published writings on eugenics, he alluded only vaguely and causally to restriction of immigration on eugenic grounds, and then only to the extent of insisting that careful, objective studies ought to be made before any groups were presumed to be “undesirable” by heredity and therefore shut out [my emphasis]” (Bell, p.418).

[12] C.E. Rosenberg, “Science and American Social Thought.” In Science and Society in the United States, eds. David D. Van Tassell and Michael G. Hall (Homewood, Illinois: The Dorsey Press, 1966), 135-162.

[13] Davenport, quoted in Black, War Against the Weak, p.101

[14] Bell, quoted in Black, War Against the Weak, p.101.

[15] Bell, quoted in Black, War Against the Weak, p.104.

[16] Black, War Against the Weak , p.104.

[17] Bell, quoted in Black, War Against the Weak, p.105.