Bargaining for Life: A Social History of Tuberculosis, 1876-1938

Bargaining for Life: A Social History of Tuberculosis, 1876-1938

Bargaining for Life: A Social History of Tuberculosis, 1876-1938

Bargaining for Life: A Social History of Tuberculosis, 1876-1938

Synopsis

"Tuberculosis was the most common cause of death in the nineteenth century. The lingering illness devastated the lives of patients and families, and by the turn of the century, fears of infectiousness compounded their anguish. Historians have usually focused on the changing medical knowledge of tuberculosis or on the social campaign to combat it. In Bargaining for Life, Barbara Bates documents the human story." "Using a wide range of sources, especially the extensive correspondence of a Philadelphia physician, Lawrence F. Flick, Bates portrays the lives of tuberculous men and women as they tried to cope with the illness, get treatment, earn their living, and maintain their social relationships. Their caretakers, including relatives, clergy, physicians, and nurses, all had their own reasons for providing help. In ways that differed with class, race, gender, and sometimes political influence, sanatoriums, hospitals, and visiting nurse societies mediated various bargains between the sick and their caretakers." "Bates concludes that the campaign to control and cure tuberculosis had little impact on the disease, but it offered care, assuaged fears of infection, and expanded the welfare system. Choices made by the sick helped to shape the institutions and affected the results of the campaign. Many of the bargains between patients and caretakers are still discernible in the U.S. health care system." "Bates has written an extraordinarily insightful book that combines social history, medical history, and nursing history. It will interest scholars, students, health professionals, and general readers who care about and care for chronically ill people." Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Excerpt

Throughout the nineteenth century, tuberculosis (or consumption as it was then called) was the most common cause of death in the United States, as in much of western Europe. Year after year, the disease sapped the strength of its victims and took its deadly toll of lives. Although individual men and women tried to escape its effects and were helped in their efforts by caretakers, there was no public outcry, no social campaign to fight the disease. Consumption developed gradually and mysteriously; it seemed beyond the reach of human control.

In the last decades of the nineteenth century, however, there emerged a new optimism about the disease and more aggressive attempts to deal with it. In 1882, Robert Koch discovered the tubercle bacillus, the bacterial cause of tuberculosis, and in 1885 Edward L. Trudeau, encouraged by the results of institutional treatment in Europe, opened the first successful sanatorium in the United States. As physicians and social leaders gradually recognized that consumption was infectious and not necessarily hopeless, they began to promulgate new laws, educational programs, and institutions with which to combat it. Two exhilarating convictions became the driving force for sanatoriums and hospitals. First, the disease was preventable. By controlling the patients’ behavior and by separating the afflicted from their families and from the rest of society, the spread of tuberculous infection could be stopped. Second, consumption was curable, at least if detected soon enough. If patients could be persuaded to live properly—an intermediate objective that also made institutionalization desirable—they could regain their health and once again become productive members of their communities.

Historians of this subject have traditionally focused on either the medical knowledge of tuberculosis, as it developed over the centuries, or on the social movement to control the disease. The protagonists in these histories are usually physicians or social reformers who led the campaign against tuberculosis. When patients appear in these stories at all, their role is typically passive: as beneficiaries of advancing knowledge and an expand-

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