Formative years: children's health in the United States 1880–2000

In his 1998 overview of the writing of medical history, John Burnham argued that recent decades have witnessed tensions between medically trained and non-medically trained historians, or what he called MDs and PhDs (John Bumham, How the idea ofprofession changed the writing of medical history, London, Wellcome Institute for the History of Medicine). There are no such tensions in Formative years in which six of the ten authors hold an MD and a PhD. The foreword, written by Leon Eisenberg (MD but no PhD), provides an impassioned plea for the teaching of medical history to medical students and the importance of contextualizing medicine. This volume is probably reflective of the peculiar breed of medical practitioners attracted to child health; as Alexandra Stem and Howard Markel remark in the introduction, "Whether revered or reviled, those who have provided medical care to children have always been involved in social, political, and cultural questions beyond the domain of the sickbed, clinic, and hospital" (p. 1). The introduction provides a useful overview of the historiography of child health in America, while the essays themselves are based on primary research, breaking new ground. Part 1 discusses the rise ofpaediatrics as a specialty. This includes a chapter by Russell Viner, based on his 1997 Cambridge PhD thesis on Abraham Jacobi, appointed to the New York Medical College in 1860 as the world's "first dedicated professor of pediatrics" (p. 23). Howard Markel discusses the relationship between public health workers and paediatricians in New York City in the Progressive era. In a fascinating chapter on incubators and ventilators for premature infants, Jeffrey Baker shows how a study of technology can reveal much about the culture of the people using it. For instance, in late-nineteenthcentury France the incubator was designed as an extension of the mother, whereas in the United States it was a substitute, "a symbol of science and of a more direct challenge of the physician to the mother's authority" (p. 71). Part 2, 'Standardizing the child', includes chapters by Jeffrey Brosco on the use of weight charts in diagnosis, Alexandra Stem on Better Baby contests and their social implications in interwar Indiana, and Heather Prescott on the social construction of "normal" adolescent growth since 1900. Again the social context is highlighted and explored. Brosco's chapter shows how an "epidemic" of malnutrition was constructed in the 1920s owing to the widespread use of weight and height charts. Ironically, the epidemic ended just as the economic depression began and one would expect an increase in malnutrition. The end of the epidemic coincided with the victory of paediatricians over public health workers; the diagnosis of malnutrition now required a more complex clinical judgement by the physician. Brosco effectively shows how the rise and fall of the epidemic had little to do with actual changes in community health. The final section of the book, ' "Discovering" new diseases in children', includes chapters by Richard Meckel on the construction of school diseases in late-nineteenth-century America, Chris Feudtner on the history of juvenile diabetes, Hugh Evans on the discovery of child sexual abuse in America, and Janet Golden on foetal alcohol syndrome in the late twentieth century. Evans describes how gonorrhoea in children, now understood to be the result of sexual abuse, was explained away as non-sexual in origin before the 1970s. Discussing a subject often hidden from view, he uses the diagnosis of gonorrhoea to show that child sexual abuse was much more prevalent than formerly believed. In the final chapter, Golden explores the acceptance of foetal alcohol syndrome as a diagnosis from 1973, linking itto the thalidomide