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 () and the () 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.
View Article and Find Full Text PDFJ Racial Ethn Health Disparities
April 2023
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.
View Article and Find Full Text PDFOliver 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.
View Article and Find Full Text PDFDespite 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.
View Article and Find Full Text PDFThis article uses quantitative and qualitative approaches to review 75 years of international policy reports on antimicrobial resistance (AMR). Our review of 248 policy reports and expert consultation revealed waves of political attention and repeated reframings of AMR as a policy object. AMR emerged as an object of international policy-making during the 1990s.
View Article and Find Full Text PDFJ Racial Ethn Health Disparities
October 2022
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.
View Article and Find Full Text PDFThere is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an 'implementation gap'.
View Article and Find Full Text PDFOriginating 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.
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