Oliver Wendell Holmes, Racism, and Remembrance.

Oliver Wendell Holmes Sr. has long been a celebrated figure at Harvard Medical School (HMS) and in the history of medicine more generally. And yet in part on account of Holmes's putative link to eugenics, but especially on account of his role as dean in the dismissal of the first three African American students at HMS in 1850, his name has recently become associated with systemic racism as well. In October 2020, the Oliver Wendell Holmes Society at HMS (one of the society "homes" to which students are assigned at admission) was renamed the William Augustus Hinton Society, in honor of the pioneering African American syphilologist. This paper examines the shifting depiction of Holmes as well as Holmes's considerations of hereditary determinism and race over the course of his long career in the nineteenth century as a test case concerning the evolving evaluation of historical figures in the history of medicine.

Regulating Homeopathic Products - A Century of Dilute Interest.

In 2015, U.S. government agencies began considering greater regulation of both homeopathic drugs and the advertising of such products. These actions came after more than a century of missed opportunities to regulate homeopathic medicines.

The Rise and Fall of the "Personal Equation" in American and British Medicine, 1855-1952.

Originating within astronomy as a technical term in the first half of the 18th century, the term "personal equation" spread into a litany of other fields including medicine, where it was used widely and variously from the late 19th century to the middle of the 20th century. We explore the personal equation in the medical literatures of the United States and Britain through a systematic analysis of over 700 articles in four prominent medical journals in conjunction with additional relevant source materials. After tracing the term's dispersion from astronomy into medically allied fields, we examine its striking polysemy while using its rich usage as a lens to examine prevailing tensions within contemporary American and British medicine. Stretching from patient and clinician variability to observer variability and error, the personal equation's various meanings reflect debates about the art and science of medical care that persist into the present day.

The Futurist and Historian Will See You Now.

Eric Topol's The Patient Will See You Now: The Future of Medicine is in Your Hands (2015) depicts a medical future in which the patient-doctor relationship is upended in the context of easily acquired and shared big data and the increasing computing power necessary to analyze such data. A chief obstacle to this future, in Topol's rendering, is the entrenched paternalism of the medical profession. But Topol's thought-provoking assessment misses other key potential obstacles to the rational and equitable implementation of this (or any) medical future and would benefit from a more nuanced telling of the history of attempts to empower patients in this country. Nancy Tomes's Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers (2016) traces the long history of patient consumerism in America. She points out that the history of attempts to inform and empower patients has often been characterized by the conflation of advertising with information, the inequitable distribution of access to information and care, and the prioritization of commercial over medical utility in the implementation of care. These remain critical obstacles to an ideal medical future, Topol's or otherwise.

Historical Perspective on the Rise and Fall and Rise of Antibiotics and Human Weight Gain.

In recent medical and popular literature, audiences have been asked to consider whether antibiotics have contributed to the rising obesity epidemic. Prominent magazines have stated that weight may be adversely affected by antibiotics that destroy existing microbiomes and replace them with less helpful ones. However, there is a long history of efforts to investigate the relationship between antibiotics and human weight gain. In the early 1950s, amid initial findings that low doses of antibiotics served as growth promoters in animal livestock, investigators explored the role of antibiotics as magic bullets for human malnutrition. Nevertheless, early enthusiasm was tempered by controlled studies showing that antibiotics did not serve as useful, nonspecific growth promoters for humans. In subsequent decades, against the backdrop of rising concern over antibiotic resistance, investigators studying the role of antibiotics in acute malnutrition have had to navigate a more complicated public health calculus. In a related historical stream, scientists since the 1910s have explored the role of the intestinal microflora in human health. By the 2000s, as increasing resources and more sophisticated tools were devoted to understanding the microbiome (a term coined in 2001), attention would turn to the role of antibiotics and the intestinal microflora in the rising obesity epidemic. Despite scientific and commercial enthusiasm, easy answers (whether about antibiotics or probiotics) have again given way to an appreciation for the complexity of human growth. History encourages caution about our hopes for simplistic answers for presumed "fat drugs" and slimming probiotics alike.

The Under-representation and Stagnation of Female, Black, and Hispanic Authorship in the Journal of the American Medical Association and the New England Journal of Medicine.

Publication in leading medical journals is critical to knowledge dissemination and academic advancement alike. Leveraging a novel dataset comprised of nearly all articles published in JAMA and NEJM from 1990 to 2020, along with established reference works for name identification, we explore changing authorship demographics in two of the world's leading medical journals. Our main outcomes are the annual proportion of male and female authors and the proportion of racial/ethnic identities in junior and senior authorship positions for articles published in JAMA and NEJM since 1990. We found that women remain under-represented in research authorship in both JAMA (at its peak, 38.1% of articles had a female first author in 2011) and NEJM (peaking at 28.2% in 2002). The rate of increase is so slow that it will take more than a century for both journals to reach gender parity. Black and Hispanic researchers have likewise remained under-represented as first and last authors in both journals, even using the best-case scenario. Their appearance as authors has remained stagnant for three decades, despite attention to structural inequalities in medical academia. Thus, analysis of authorship demographics in JAMA and NEJM over the past three decades reveals the existence of inequalities in high-impact medical journal authorship. Gender and racial/ethnic disparities in authorship may both reflect and further contribute to disparities in academic advancement.

An Awkward Fit: Antimicrobial Resistance and the Evolution of International Health Politics (1945-2022).

Despite being acknowledged as a major global health challenge, growing levels of antimicrobial resistance (AMR) in pathogenic and commensal organisms have proven an awkward fit for international health frameworks. This article surveys the history of attempts to coordinate international responses to AMR alongside the origins and evolution of the current international health regulations (IHR). It argues that AMR, which encompasses a vast range of microbial properties and ecological reservoirs, is an awkward fit for the 'organismal' philosophies that centre on the rapid control of individual pathogens that have characterised international policy-making since the 19th century.

William A. Hinton (1883-1959): Diagnosing and Confronting Racism in the Medical Profession.

Racism impacts every aspect of medicine, including the careers and lives of Black physicians. The story of William Augustus Hinton (1883-1959), who invented the Hinton Test for syphilis before becoming the first African American full professor at Harvard University in 1949, offers an instructive perspective on the intersection of interpersonal and systemic racism, and personal determination, just over our historical horizon. Yet there are sobering and instructive lessons throughout this history. Hinton had to navigate prejudice throughout his career. Indeed, while there is much to be inspired by in the telling of Hinton's story, the forms of racism faced by Hinton and his contemporaries remain persisting features of academic medicine. This article focuses on encounters with racism that affect the course of medical careers and scientific innovation. Hinton's story holds important implications for many health professionals in the twenty-first century and provides unique insights into the history and impact of interpersonal and systemic racism alike in academic medicine.

Insights from full-text analyses of the Journal of the American Medical Association and the New England Journal of Medicine.

Analysis of the content of medical journals enables us to frame the shifting scientific, material, ethical, and epistemic underpinnings of medicine over time, including today. Leveraging a dataset comprised of nearly half-a-million articles published in the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM) over the past 200 years, we (a) highlight the evolution of medical language, and its manifestations in shifts of usage and meaning, (b) examine traces of the medical profession's changing self-identity over time, reflected in its shifting ethical and epistemic underpinnings, (c) analyze medicine's material underpinnings and how we describe where medicine is practiced, (d) demonstrate how the occurrence of specific disease terms within the journals reflects the changing burden of disease itself over time and the interests and perspectives of authors and editors, and (e) showcase how this dataset can allow us to explore the evolution of modern medical ideas and further our understanding of how modern disease concepts came to be, and of the retained legacies of prior embedded values.