[Ethics and the severina condition in the mangrove swamps of Capibaribe]

João Cabral de Melo Neto's poem "Morte e vida severina" focuses primarily on the satisfaction of human needs and on the condição severina--i.e., the poverty, hunger, joblessness, injustice, and early death that characterizes much of life in Northeast Brazil. In two episodes of the poem, human life is presented as a value ideal: during the dialog between the master carpenter and the protagonist Severino (a retirante, or migrant fleeing drought-stricken areas of the Northeast) and likewise during the birth of another Severino, on the banks of the Capibaribe River in Recife.

Containing and preventing contagious disease: Montreal's Protestant school board and tuberculosis, 1900-1947

In this period, Montreal was the most unhealthy city in Canada owing to widespread poverty, abysmal living conditions, inadequate public health, and a dependence upon private charities to provide health and welfare services. While Montreal's Protestant school board assumed a pivotal role in the war on tuberculosis by early identification of consumptive pupils, educating those in treatment, and prevention, these initiatives were tempered by a conservative view that equated poverty with moral degeneration. School board minutes provide a window onto commissioners' construction of health, the nature of the relationship between a school and its community, and the factors which influenced their decisions.

Understanding household limitation strategies among the sixteenth-century urban poor in France

This essay explores what we can learn about the household limitation behaviour and strategies of those members of sixteenth-century French society who numbered among the mass of the poor. In particular, it focuses on the evidence produced by urban poor relief councils and hospitals, as they recorded the circumstances of the poverty-stricken clientele for their administrative records, and presents some preliminary findings. Although contraceptive methods do not feature explicitly in petitions and supporting documents, it is possible to build up a modest picture from these sources of the kinds of household limitation techniques available to the urban poor. As this essay demonstrates, in some cases, these involved reproductive strategies, yet in other cases it may be more appropriate to speak of household limitation methods.

Unraveling the mystery of why there was no childhood lead poisoning

Despite widespread use of leaded paints, classic life-threatening lead poisoning in small children began to be diagnosed as such only in the 1914-30 period. The diagnosis became suddenly more common in the 1950s and 1960s, but only in some areas of the United States. Experts focused on interior leaded paints as the source of the poison. Archival study of cases from Cincinnati and material from Denver, along with reevaluation of the medical literature, suggests that the problem should be reframed in terms of localized accident, not an epidemic. Very likely clinicians' reports accurately reflected social and material reality. Housing patterns hitherto not fully explored or understood explain why diagnoses were or were not reported. Moreover, evidence suggests the hypothesis that exterior (not interior) paint applied to middle-class houses (not mansions) may account for most cases not traced to repainted furniture and windowsills.

'A ticklish sort of affair': Charles Mott, Haydock Lodge and the economics of asylumdom

In June 1846 complaints about the treatment of a Welsh clergyman at the privately run Haydock Lodge Asylum in England heralded a series of allegations about maltreatment of pauper patients at the institution. These prompted a number of Parliamentary reports on the institution. Allegations were also made about connections between the asylum and officials at the Poor Law Commission. This article demonstrates that many of the problems at Haydock Lodge relate to the character and personal circumstances of its first Superintendent, Charles Mott, a former Assistant Poor Law Commissioner. Despite this specific causation, the Haydock Lodge affair had a more general influence in raising once again questions about the propriety of entrusting the care of publicly funded patients to private institutions.

When push comes to shove: sites of vulnerability, personal transformation, and trafficked women's migration decisions

Discussions of the push and pull factors behind trafficked women's decisions to migrate abroad for tenuous work opportunities in the "entertainment" sector tend to variously privilege poverty, familial obligations, and, more recently, personal opportunism. This reinforces more general observations about motivations for "Third World" women who migrate to more developed regions globally. Although these factors are indeed important, the author's research has revealed the relevance of other explanations for migration decisions, including the prevalence of domestic violence, family dissolution, and escape from personal circumstances, which are themselves products of low self-esteem and sense of self-worth.

"Stop this overwhelming torment of destiny": negotiating financial aid at times of sickness under the English Old Poor Law, 1800-1840

The issue of entitlement under the English Poor Law (1601-1834) is a complex question, and nowhere more so than in the context of the sick poor. Using the example of communities in one of England's most parsimonious Poor Law counties, Lancashire, this article will show that the sick poor faced uncertain and uneven entitlement to relief and medical intervention. Faced with such uncertainty, they adopted three core linguistic and posturing strategies when attempting to establish their eligibility for relief in the eyes of Poor Law officials. Pauper letters and the correspondence of overseers of the poor and vestries are used to unpick the process of obtaining poor relief and to highlight the subtle strategization of pauper applicants. The article concludes by suggesting that there may have been a regional patterning in access to medical relief in England in the last decades of the Old Poor Law.

[Public health in eastern Skania 1860-1899--a study based on district medical officer's reports]

During the last decades of the 19th century Sweden changed from being a developing to a developed country. It was a period when many people emigrated to America and Denmark, due to miserable times. The aim was to investigate the status and development of the public health in the eastern part of the province Skane, Sweden, during the years 1860 to 1899. The investigation included a study of differences in health between city and countryside, men and women, and health problems now and then. The official reports of provincial doctors (general practitioners) from Brosarp (1860-1899) and city doctors from Kristianstad (1883-1899) were studied. The reports included conscription reports, tables of illnesses and deaths, and an annually summarized health report of the district. The district of Brosarp was a very poor area, due to its topographical location. The poverty brought illness, but not as much as could be expected. The infant mortality rate was lower than for the rest of the country. The long distances between the villages impeded the transmission of infectious diseases. The health situation in Kristianstad was also affected by its topographical location. The humid and densely populated city was a hotbed for infections. Sanitary improvements in both Brosarp and Kristianstad resulted in a better health situation at the end of the 19th century. There were several similarities between the studied areas and the developing countries of today, for example regarding malnutrition, traditional medicine and problems with contaminated drinking water. Compared to the health problems of today, poverty and infectious diseases were greater problems during the studied period of time, while problems related to diet and alcohol drinking were similar. More research is needed to relate the public health in Brosarp and Kristianstad to that in other Swedish districts during the same period of time.

Lo Spedale di Poveri, the Hospital for the Poor in Milan: 15th to 20th Century

The construction of the Hospital for the Poor was begun in Milan in 1451 at the instigation of Francesco Sforza, Duke of Milan. In contrast to what had happened during the Dark Ages of the Medieval period, the new hospital was extraordinary both in construction and in medical organization. Wards for the patients were separated according to diseases, infective and noninfective, and according to sex. Each patient had his or her own bed and was fed adequately and kept warm. Patients were no longer treated by astrologers or monks but rather by doctors who had studied medicine at the University of Pavia. Each ward had its own doctor and surgeon, and from 1558 on, there was a doctor on duty in the hospital 24 hours a day. The hospital had its own pharmacy and drug reference book. The Hospital for the Poor, or Cà Granda (Big House), or the Ospedale Maggiore, as it was variously called from the 15th to the 19th centuries, became a training ground for anatomic and clinical studies. It was only in 1929 that a Faculty of Medicine was set up at Ospedale Maggiore.

Diaspora, dispute and diffusion: bringing professional values to the punitive culture of the Poor Law

From the 1870s to the 1920s Poor Law institutions in England developed from destinations of last resort to significant providers of health-care. As part of this process a general professionalisation of Poor Law work took place. The change was facilitated by wider social, philosophical and political influences in nineteenth century England. The introduction of trained nurses into the Poor Law was part of a diaspora of both ideas and people from voluntary institutions and organisations. Unrecognised in 1834, nurses eventually became the most numerous class of workhouse officers. This was not accomplished without dispute and acrimony. As a group and as individuals nurses were often at the centre of disputes. Utilising a social history framework and drawing on contemporary written sources, including Poor Law and nursing journals, this paper highlights the role played by Poor Law nurses in the diffusion of values and attitudes that helped to transform the workhouse regime from one of punishment to therapy.

Therapy of kidney diseases in poor people in France during the 18th century

The idea of using simple and easily available remedies to treat different diseases is typical of ancient medicine and one of the first examples can be found in Galen's works. This type of Medicine was called ""Medicine for the poor"" in the 18th century. This expression refers to the use of simple substances, available in nature, like plants, herbs, flowers, fruit, minerals etc, to treat some of the more common diseases. Evidence of this tendency in the early 18th century is a textbook of Medicine written in France by Dubé in 1669. This work has been reprinted several times, and translated from French into English in 1704 and into Italian in 1715 by Sebastiano Castellini. In his work Dubè describes the therapeutic remedies made with natural substances. Some of these substances were used to treat renal diseases, in particular nephrolithiasis, kidney and bladder inflammatory disease, renal ulcer, dysuria and incontinence.

[Hunger, solidarity, and ethics: discourse analysis of the movement Citizen's Action against Hunger and Poverty and for Life]

The article analyzes the discourse of Citizen's Action against Hunger and Poverty and for Life, a social movement led by sociologist Herbert de Souza (Betinho) that was at its peak between 1993 and 1994. From the perspective of certain concepts and principles introduced and disseminated by so-called bio-ethics, the present study identifies within this campaign an attempt to construct a social movement in Brazil displaying characteristics quite similar to those associated with 'practical ethics'. These features are apparent in the three major principles that the movement applied as strategies for fighting hunger and poverty - to wit, solidarity, partnership, and decentralization.

Poverty, gender and incarceration in sixteenth-century Paris

The experience of prison remains a relatively little-studied aspect of late-medieval and early-modern criminalization of the activities of the poor. This study examines how poverty and gender influenced incarceration practices, treatment and release in sixteenth-century Paris. A study of the archives of the ecclesiastical gaol at Saint-Germain-des-Prés from 1537 to 1579 suggests that both poverty and gender affected the crimes for which women and men were imprisoned, the length of time they remained in detention and the reasons for their release.

'Embarrassed circumstances': gender, poverty, and insanity in the West Riding of England in the early-Victorian years

Gender assumptions in early-Victorian England held that men derived their identities from work, while women were dependent beings for whom employment was not a central component of identity. Yet just as the New Poor Law positioned women ambiguously, sometimes emphasising women's dependency and other times stressing women's ability to work, so too do asylum records reveal complicated relationships between gender, poverty, and employment. Patient case notes from the West Riding Pauper Lunatic Asylum suggest that employment was a central component of poor women's identities. Female insanity was sometimes attributed to a lack of work, and both medical practitioners and female patients expected poor women to be employed.

A pauper dead-house: the expansion of the Cambridge anatomical teaching school under the late-Victorian poor law, 1870-1914

In May 1901 an article appeared in the Yarmouth Advertiser and Gazette entitled ‘Alleged Traffic in Pauper Corpses—How the Medical Schools are Supplied—The Shadow of a Scandal’. It recounted that, although a pauper named Frank Hyde aged fifty had died in Yarmouth workhouse on 11 April 1901, his body was missing from the local cemetery. The case caused a public outcry because the workhouse death register stated that Hyde had been “buried by friends” in the parish five days after he had died. An editorial alleged that “the body was sent to Cambridge for dissection” instead and that the workhouse Master's clerk profited 15 shillings from the cadaver's sale. Following continued bad publicity, the visiting committee of Yarmouth Union investigated the allegations. They discovered that between 1880 and 1901 “26 bodies” had been sold for dissection and dismemberment under the terms of the Anatomy Act (1832) to the Cambridge anatomical teaching school situated at Downing College. The Master's clerk staged a false funeral each time a pauper died in his care. He arranged it so that “coffins were buried containing sand or sawdust or other ingredients but the body of the person whose name appeared on the outside [emphasis in original]” of each coffin never reached the grave. This was Hyde's fate too. Like many paupers who died in the care of Poor Law authorities in the nineteenth century, Hyde's friends and relatives lacked resources to fund his funeral expenses. Consequently, he underwent the ignominy of a pauper burial, but not in Yarmouth. His body was conveyed on the Great Eastern railway in a “death-box” to Cambridge anatomical teaching school. Following preservation, which took around four months, the cadaver was dissected and dismembered. It was interred eleven months after death in St Benedict's parish graveyard within Mill Road cemetery, Cambridge, on 8 March 1902. A basic Christian service was conducted by John Lane of the anatomy school before burial in a pauper grave containing a total of six bodies. The plot was unmarked and Frank Hyde disappeared from Poor Law records—the end product of pauperism.

Diet and nutrition in poor and minority communities in the United States 100 years ago

Atwater and his colleagues began studying food consumption in the closing years of the nineteenth century and from the very start devoted much effort to collecting data from poor and minority households. This paper reviews some of the fruits of these labors, particularly from the standpoint of what they contribute toward a better historical understanding of American food habits and nutrition. It surveys dietary data from African American, Appalachian white, Mexican American, native-born poor, and immigrant households. These data shed light on several areas of historical concern, including rural versus urban nutrition, seasonal hunger, class disparities, and food-habit change. I suggest the economically and culturally diverse sample of dietary patterns that comes to us as a legacy of the Atwater era sets the stage for a history of American food habits considerably more sophisticated than has been realized to date.

A cultural and economic history of old age in America

The lives of today's elderly population have deep historical precedents by which we can better understand current social policies, health care, and retirement. The history of old age in America is more complex and varied than most people realize. This history has been shaped largely by the search for economic security. In the agricultural economy of preindustrial America, few individuals saved sufficient resources for their declining years, and most elderly people either continued to work or lived in dependent poverty. More than any other factor, the lack of family members willing or able to provide for an elderly relative resulted in the relative moving to the dreaded poorhouse. Passage of Medicare and Medicaid legislation resulted in the rapid development of commercial nursing homes, accelerating the trend away from nonprofit and government facilities. However, serious deficiencies in care have continued to occur, prompting additional federal legislation. Knowledge of the history of aging in America can provide a useful touchstone: it can expose past problems that could happen again, identify what is worth preserving from the past, and help us avoid relearning painful lessons.

A history of noma, the "Face of Poverty"

Noma (necrotizing ulcerative stomatitis, stomatitis gangrenosa, or cancrum oris) is a devastating orofacial gangrene that occurs mainly among children. The disease has a global yearly incidence of 140,000 cases and a mortality rate of approximately 90 percent. Patients who survive noma generally suffer from its sequelae, including serious facial disfigurement, trismus, oral incontinence, and speech problems. The medical history of noma indicates that the disease was already known in classical and medieval civilizations in Europe. In the sixteenth and seventeenth centuries, Dutch chirurgeons clearly described noma as a clinical entity and realized that the popular name "water canker" was not sufficient, because this quickly spreading ulceration in the faces of children was different from "cancer." In the eighteenth century, awareness that noma is related to poverty, malnutrition, and preceding diseases such as measles increased in northwestern Europe. In the first half of the nineteenth century, extensive surgical procedures were described for the treatment of the sequelae of noma. At the end of that century, noma gradually disappeared in the Western world because of economic progress, which gave the poorest in society the opportunity to feed their children sufficiently. Only in the twentieth century were effective drugs (sulfonamides and penicillin) against noma developed, as well as adequate surgical treatment for the sequelae of noma. These modes of treatment remain inaccessible for the many present-day victims of noma because of their extreme poverty. The only truly effective approach to the problem of noma throughout the world is prevention, namely, combating the extreme poverty with measures that lead to economic progress. In the meantime, medical doctors in the Western world should not forget their own history and ignore this global health problem; rather, they should face "the face of poverty" with the eyes of mercy and concern suited to their profession.