Mothers' health and babies' weights: the biology of poverty at the Melbourne Lying-in Hospital, 1857-83

Birth weight remains a major focus of medical research into the relationship between pre-natal growth and life course health, and historians have used mean birth weight to assess women's standard of living. However, there are intrinsic difficulties in inferring maternal health and nutritional status from birth weight, and some of the known data sets produce puzzling results. One rich data set comes from the Melbourne Lying-in Hospital, 1857-83, and the article discusses the complex institutional, social, and economic causes that may underlie its apparently counter-intuitive anthropometric results. This data set reveals the biological effects differential social conditions can inflict, even within an otherwise affluent society.

Epidemiologists explain pellagra: gender, race, and political economy in the work of Edgar Sydenstricker

Between 1900 and 1940, at least 100,000 individuals in the southern United States died of pellagra, a dietary deficiency disease. Although half of these pellagra victims were African-American and more than two-thirds were women, contemporary observers paid little attention to these gender and racial differences in their analyses of disease. This article reviews the classic epidemiological studies of Joseph Goldberger and Edgar Sydenstricker, who argued that pellagra was deeply rooted in the political economy of cotton monoculture in the South. The methods that Sydenstricker brought to epidemiology from early work on political economy obscured the role of gender inequalities in pellagra, and his focus on economic underdevelopment led him to ignore the prominent role of African-Americans as pellagra's principal victims. Research methods and traditions, no less than more overt ideologies, played a role in maintaining the subordinate social position of women and African-Americans in the southern United States.

[The Wurzburg professor of physiology and medical offer for the poor Johann Joseph Dömling (1771-1803) - an almost forgotten pioneer of the romantic medicine]

Johan Joseph Dömling (1771-1803), professor of physiology and medical officer for the poor at Wurzburg, was born in a Franconian village near to Königshofen. For a while, he supported a mechanistic oriented physiology and rejected the Romantic medicine. In his early works he polemicized vehmently against the natural philosophy and anthropology of Schelling. About the year 1802, Dömling changed sides and so he even paved the way for Schelling and his successful activities at Wurzburg (1803-1806) as a pioneer of the Romantic medicine in Germany. Dömling's early death gave rise to speculations, rumours and intrigues so that finally Philipp Joseph Horsch, the physician of Dömling, was accused of having murdered him. Franz Berg, professor of theology at Wurzburg, was the creator of that rumours. Berg supported enlightened philosophical concepts, and so he was strongly opposed to Schelling and Horsch. A well-grounded scientific study about Dömling's life and work is up to now a desideratum of the research in medical history.

The socio-economic impacts of rice policies implementation in rural Burma/Myanmar

This paper, focusing on two rice-farming villages where the Burmese government has experimented with a variety of agricultural programmes, explores the problems associated with rice implementation processes. In particular it looks at the basic structure and operation of agricultural administration — salary and income of government officials, the predominance of military officers in civilian ministries and departments, the creation of departments with overlapping responsibilities, and the hierarchical structure of the Agricultural Ministry — and highlight their limitations. It provides another aspect to evaluating the roots of poverty among average rice farmers.

["Bread from stone and spiritual uplift for illiterates"--paternalistic community health promotion 200 years ago]

Some of the early pioneers of community health promotion in Norway were clergymen. One of these "potato priests", as they often are referred to, was the Rev. Niels G.A. Dahl (1778-1852) in Gulen, a poor rural district in western Norway. In a spirit of paternalism he engaged in many non-religious activities promoting the lives and health of his congregation. He engaged in vaccination, medical treatment, control of infectious diseases and provision for the poor, hired a midwife, struggled hard against heavy liquor drinking among locals and promoted primary education. This article highlights Dahl's contributions to community health promotion. Effective community health promotion depends on local knowledge, as well as local authority, influence and personal engagement. Maybe a dose of the paternalistic spirit is called for also in today's health promotion?

Treating Ulster's rural poor: the county infirmaries of Armagh and Down 1766-1851

This paper considers the role of county infirmaries in providing health care for the inhabitants of two counties in south-east Ulster. It traces the establishment and management of these institutions from their beginnings shortly after the passing of the Infirmaries Act (1765) to the middle of the nineteenth century. From the available evidence, the accommodation, staff, patient numbers and diet of the infirmaries are considered and an assessment of their efficacy in offering a valuable service to their communities is discussed.

[Malnutrition in XIXth century Naples]

In the second half of the XIXth century, after the unification of Italy, researches and enquiries that had the objective of investigating links between malnutrition and disease were promoted in the city of Naples, the former Capital of the Kingdom of the Two Sicilies. The philosophy underlying these scientific efforts, devoted to the benefit of the lower classes of the population, derived from the famous enquiry into the conditions of the Provinces of the Kingdom of Naples, promoted by the enlightened government of Joachim Murat in 1811. By necessity, the researchers had to address, with the methodological limits of the period, the complex interactions among social, environmental, medical, hygienic and physiologic factors, attempting to enucleate strategies of prevention and of active intervention. The works of Achille Spatuzzi, Luigi Somma, Errico De Renzi and Luigi Manfredi, demonstrated the persistence of poverty and malnutrition among the lower classes of the Neapolitan population and had the merit of being among the first in explicitly recognizing the association between inadequate dietary intake, relative to the needs of the organism, and major diseases, such as rickets, tuberculosis, and anemias.

[Poverty, illness, prayer--thoughts on contemplating the votive painting of St. Notburga]

A votive painting in the chapel of St. Donatus in Pavlovec (northern Croatia) from the 18th century depicts St Notburga of Eben with two paupers, a shepherd and an invalid. Although generally venerated as patron-saint of peasants and maids, Notburga seems to have captured the imagination of the anonymous painter as the helper of the poor and underprivileged. The vicious circle of poverty and disease is evoked by this painting, as well as the popular belief in divine assistance by supplication to patron saints.

Poor, ill, and sometimes abandoned: tubercular children in Buenos Aires, 1880-1920

Ill children with chronic diseases, such as tuberculosis, have faced difficult lives. Poverty proved a factor in their susceptibility to disease, their abandonment, and their treatment. When public health policies in Buenos Aires shifted from ignoring children to viewing them as victims who needed protection, government agencies, charitable organizations, public schools, and hospitals developed special programs that emphasized both prevention and cure of childhood tuberculosis. Argentine physicians and hygienists supported programs that were similar to those in Europe and the United States. Despite efforts, from 1880 to 1920, diagnosis of tuberculosis remained problematic, health professionals failed to prevent tuberculosis in children, and physicians were unable to cure the disease.

Life and death of the people of London: a historical GIS of Charles Booth's inquiry

Social reformer Charles Booth undertook a massive survey into the social and economic conditions of the people of London at the end of the 19th century. An important innovation of his Inquiry was the construction of large, detailed maps displaying social class of inner London on a street-by-street basis. These provide a detailed and vivid picture of the geography of poverty and affluence at this time. These maps have been digitised, georeferenced and linked to contemporary ward boundaries allowing Booth's measurement of social class to be matched to the measurement of social class in the 1991 census of population and standardised mortality ratios derived for all causes of death in the survey area between 1991 and 1995. The social class data were used to derive an index of relative poverty for both time periods and a comparison of the geographies of relative poverty and their relationship with contemporary mortality was made. Although the overall standard of living had increased, the geography of poverty at the end of the 19th century was very similar to that at the end of the 20th century. Moreover, the geography of all causes of death for people over the age of 65 was more strongly related to the geography of poverty in the late 19th century than contemporary patterns of poverty. This relationship was also true for mortality for specific diseases that are related to deprivation in early life. The paper concludes that the spatial patterns of poverty in inner London are extremely robust and a century of change has failed to disrupt it.