Anthro week 2

Week 2 
 
Reading 1: Lock and Nguyen (2018) 
 
 
video:  

● concept of ‘normal’ - what comes to mind when we discuss ‘normal bodies’ - what could be problematic about 
applying the idea of ‘normal’ across culture/time/instances of health and disease  
● how did our ideas of what is normal develop? Going back in time, physician John Snow (founder of modern 
epistemology ; study of patterns of disease), traced water sources in research of cholera. - marked beginning of 
systematic study of disease, and a change in scientific thinking in identifying and classifying nature (for better 
understanding). Beginning of modern scientific thinking  
● development of scientific thinking : wonder->truth (rather than thinking of phenomenons/wonders, we are now 
identifying objective truth)  
● moral economy - principles that guide behavior. rules to guide scientific behavior: shared values about how to 
conduct science  
● epistemic virtue - agreed-upon qualities scientists had that were thought to be reliable (choices of techniques) 
choices and techniques used to comprehend nature that are thought to be reliable (to find knowledge)  
● objectivity: non-biased, when a person is not influenced by personal feelings or opinions/personal values when 
making observations, and when considering and representing facts - important aspect of the scientific method 
● truth to nature: idea of finding and identifying ideal forms of everything in nature  
● trained judgment : idea that we must rely on experts and years of training in order to understand the world best  
● norm: term used to talk about social culture standard has standards of acceptable and unacceptable 
behaviors.when relating to health, used to describe/prescribe characteristics that are desirable/undesirable. 
designating some characteristics as good, desirable, or permissible and others as bad, undesirable, or 
impermissible. a norm in this sense means a standard for evaluating or making judgements about what is normal 
and abnormal  
● normative: established standards. establishing, relating to, or deriving from a standard  
● normal: has two meanings: 1, fits within or in with a statistical average/range (in the case of medical testings); 
and 2, what your body/health is souposed to, or ’ought’ to be like  
● whats the problem? the development of scientific thinking has led to the normalization of the body and disease. 
we have established standards of what is normal and health, people who fall outside of that standard are 
considered abnormal, unhealthy and pathological. - this becomes problematic because modern clinical 
biomedicine we are not taking into account cultural socionomic and biological differences among people that 
may come into play in terms of what a health/normal range m ay be. (labour time among different races/groups 
of women, for example)  

Keywords: 

● Biomedicine ​- Biomedicine is the product of specific historical circumstances during which systematic efforts 
were made to understand nature, using techniques designed to produce an objective description of the material 
world. the branch of medicine concerned with the application of the principles of biology and biochemistry to 
medical research or practice. 
● Normative - ​establishing, relating to, or deriving from a standard. Norm and normal, the statistical and the 
moral, became conflated in this understanding of variation as deviations. Individual bodies were ‘normalized’ 
both biologically and statistically. Once the material characteristics of individual bodies were described and 
quantified, they were then assessed against ‘normal’ values established by statistical surveys of ‘healthy’ 
populations. e.g.: blood test. the idea of normal is understood as normative (what it takes to be healthy), and is 
also very often equated with what is morally right (the range where individuals ‘ought’ to be).  
 ● Norm​ - designating some characteristics as good, desirable, or permissible and others as bad, undesirable, or 
impermissible. A norm in this sense means a standard for evaluating or making judgments about what is 
normal/abnormal (i.e., healthy/unhealthy). 
● Moral economy​ - the set of rules that guides scientific behaviour. Shared norms and values related to practicing 
science.   
● Epistemic virtue​ - agreed upon qualities or character traits that are thought to be reliable (e.g., scientific 
objectivity). Scientists rely on their epistemic virtues in order to gather information about the world and 
construct new knowledge.   
● Miasma theory ​-​ ​an obsolete medical theory that held diseases (such as cholera, chlamydia, and plague) were 
caused by miasmas, i.e., harmful air or pollution. 
● Pluralism ​-  

 
Questions: 

1. Define and explain the difference between normal (meaning statistical average) and normal (meaning morally 
right) in the context of the reading.  
2. Describe Jon Snow’s ​relationship to Daenerys Targaryen​ contribution to the current acceptance and use of the 
germ theory of disease. 
3. Explain the three epistemic virtues (truth-to-nature, mechanical objectivity, and trained judgement) and how 
these characteristics of scientific practice shifted ways of understanding the world. (p. 33) 
4. Brain death is detected with similar biomedical technologies across cultures but how is brain death interpreted 
and acted up differently in North American and Japanese cultures? (p. 38) 
5. What did the 1930s study from United States, exploring whether or not children should have their tonsils 
removed reveal about the nature of medicine?  
6. Describe the difference between an ‘internalizing’ discourse and ‘externalizing’ discourse in European 
medicine. 
7. Critical thinking question: What is problematic about identifying normal/healthy bodies using standardization of 
the bodies and diseases? (e.g., using a bell curve to explain the range for “normal/healthy” and identifying 
instances outside the curve as “abnormal/pathological”) 

  
 
 

1. Use the following two examples to illustrate the dangers of defining “normal” and identify the consequences of 
those decisions: (a) Childbirth practices among the Inuit; (b) Hormone replacement therapy for menopausal 
women.  

 
Reading 2: Půtová (2018) 
 
Keywords: 

● Eurocentrism ​- the perspective that falsely assumes the superiority of Western European cultural values over 
those of non-European societies. 
● Anthropometry​ - the scientific study of the measurements and proportions of the human body. 
● Freak show​ - An outdated and offensive term for the exhibition of humans for entertainment purposes. 
Referred to in popular culture as "freaks of nature", the bodies or behaviours of these individuals deviated from 
Eurocentric standards of normal.   
● Exoticism​ - the quality of being unusual and exciting because of coming (or seeming to come) from far away. 
● Impresarios ​- organizers of freak shows. 
 ● Microcephaly ​- is a condition seen at birth where the size of an individual’s head is much smaller than normal. 
The condition may arise from genetic issues or when the fetus is exposed to certain viruses/toxins during 
pregnancy.  
● Imperial colonialism ​- The domination of the political/economic/cultural life of one country/culture over 
another that is accomplished by seizing political control, occupying the land with settlers, and exploiting 
region/people economically.   

 
Questions: 

1. How was Darwin’s theory of evolution used to justify colonial expansion and create a hierarchy among 
non-European cultures?  
2. What kinds of people were included in a typical freak show and how were they treated?  
3. What were the true objectives of freak shows? What was the role of the impresario in achieving these goals?  
4. What lies did Barnum fabricate in order to increase the success of his shows?  
5. Critical thinking question: What do you think makes Barnum’s treatment of people and the exploitation of their 
bodies so repugnant by today’s standards?   
6. Define Völkerschauen. In addition to people, what else was on display at this form of show?  
7. What factors led to the decline of the freak show?  

Freak show reading notes

- f freak shows as a form of an inhuman and Eurocentric approach to the physical and
cultural differences of people from non-European cultures or to the physically
handicapped
- their otherness became the subject of exhibitions and other forms of public presentation
taking place mainly in circuses, zoological gardens or wax figure museums.
- Freak shows accentuated particularly the exotic features of the exhibited individuals,
their morphological differences, deviations and anomalies differing from the norm of the
European population.
- 19th century ->colonial expansion of the Europeans -> exoticism and differences
- . Colonized non-European native cultures and indigenous people added another layer of
difference to the phenomenon of exoticism.
- This was partly due to formation of European national identities when national countries
originated.
- perspective of Eurocentrism was additionally enhanced by the interest of the European
natural scientists in racial classification, one grounded in description and measurements
of physical features (anthropometry) intent on revealing the relations between different
races.
- exotic picture of the members of non-European cultures or physically handicapped
people evoked the triumph of Western civilization
- Body proportions and morphological features of tribal people from colonies were
systematically compared with the morphology and anatomy of Europeans and
consequently often abused as an ideological tool confirming the superiority of civilized
nations over indigenous cultures that were relegated to the level of savagery and
barbarism
- benchmark of civilizational advancement = Western man, represented by the Caucasian
race - proclaimed as superior to other races for its alleged aesthetic beauty and corporal
harmony
- Darwin's theory of biological evolution -inspired-> scientists to search for the missing
evolutionary element between the ape and the civilized Western man ->Some racial
scientists claimed that the evolutionary element were black people or Native Americans
- data and information used to study exotic cultures -> received from travellers,
missionaries or people working in colonial administration (believed and perceived to be a
strongly academic)
- Freak shows included presentation of members from non-European ethnic groups,
physically different people whose appearance caused amazement, wax figures and
exotic animals.
- First half of 19th century: freak shows became part of zoological gardens,
special exotic villages, circuses, anatomic museums, wax figure museums,
cabinets of curiosities, exhibitions and fairs
- the evolutionary theory divided the world into colonies that created the monstrosity of
the nonEuropean world, "the world of savages".
- Native Americans were some of the few indigenous regarded rather positively in the
19th ce Europe
- Other non-European indigenous people, for instance Aboriginal Australians or African
Khoikhoi, San people and Zulu were considered as human beings distinguished by
monstrosity, animality or physical anomaly - ethnic groups and native tribes whose
members were presented as people on the technologically lowest level of culture
- In addition to racial inferiority and superiority, the existence of freak shows contributed to
establishing hierarchy and normality, introducing an order
- A savage presented by theatrical means as a coloured, different or abnormal
monster evoked fascination, fear and amazement. At the same time, these
presentations contributed to the reproduction of cultural stereotypes, education
and knowledge
- The origins of the freak shows date back to the beginnings of zoological gardens and
parks in Europe at the turn of the 18th and 19th century, especially in Paris (1793),
Madrid (1822) and London (Regent's Park, 1824)
- Non-European indigenous people started to be presented as exotic subject evoking
laughter and amusement
- The objective was to innovate and extend the exhibition portfolio, attract more visitors,
offer a new attraction to the public and to aid economic decline most European
zoological gardens faced
- opularity of freak shows peaked approximately at the turn of the 19th and 20th century.
- Freak shows accentuated particularly the exotic features of individuals, their bodily
otherness, physical handicaps, actual or presumed anomalies and any deviations from
European population norms
- simple freak shows were held in the United Kingdom at the beginning of the 19th
century, they later underwent transformation, consolidation and became popular
 especially around the middle of the century when commercial shows experienced
a boom. At the beginning of the 20th century people could still marvel at, educate
and amuse themselves by looking at Siamese twins, bearded ladies, dwarfs,
giants, albinos, monkey woman and monkey man and other abnormal creatures
- Saartjie Baartman: African woman from the Khoisan tribe, brought to London in 1810 by
the British doctor William Dunlop. nicknamed Hottentot Venus, was shown under
humiliating conditions in marketplaces and circuses until her death in 1815. What evoked
laughter, surprise and amusement in the public was particularly her buttocks and
genitals, perceived as oversized and abnormal.
- pinched her, another walked round her; one gentleman poked her with his cane;
and one lady employed her parasol to ascertain that all was, as she called it,
natural
- After her death, her body was passed to the National Museum of Natural History
in Paris for the purpose of further research, measuring, making plaster casts and
organ preservation
- the Great Exhibition in London in 1851: awoke interest in the indigenous people from
colonies. A part of the London exhibition was dedicated to India, considered "half the fun
of the whole show". including its products from silk and cotton. However, presentations
of other colonies, including New Zealand and Australia, played only a marginal role here,
as the exhibition was primarily concentrated "round the economic sun of Britain.
Colonies – their indigenous people and artefacts – were given a special space at
colonial exhibitions that took place,
- Organizers of freak shows – impresarios, usually focused on shows presenting primarily
physical differences of individuals that could be accompanied by acrobatic or other
artistic abilities. Freak shows took places in zoological gardens, circuses, museums,
rented buildings and halls, provisory wooden huts, tents in squares or at places intended
where funfairs or markets were usually held. For the organizers, it was important to
simulate the routine life of indigenous people in a village through which visitors could
walk and participate in various activities. Figure museums and anatomic museums
presented a special form of these shows, where human curiosities were usually shown
sitting at elevated places, or in front of special stage sets within which visitors could walk
like in a museum. Every curiosity had a description tag specifying the origin, age and
details of the body
- Interest in and desire to see human freaks was stimulated not only by impresarios, but
also by traders in colonies, colonial office workers and missionary societies. This in turn
was enhanced by positive reactions of the public that required more exoticism, more
colonial products and more native populations living under the ‘civilized’ custody of the
white man.
- Organizers usually searched for new and fresh human freaks with distinctive features
and abilities, or for people who could be incorporated into a show.
- focused on commercial success, which is why they also took advantage of stereotypes
and presentation clichés in a manner that corresponded to the purpose to satisfy the
public expectation
- Every new type of difference was linked to a certain dramatic repertoire that was
repeated, with slight variations, over and over again at almost all shows; the public knew
it well and expected it.
- Another feature that mattered was a unique appearance and its authenticity, connected
to a story about discovery and origin.
- For this purpose, impresarios published "publicity pamphlets, which were for sale
at their appearances to a distinct race hitherto unknown to civilization"
- Impresarios, via their traders or agents, acquired individuals and groups from different
geographic and cultural areas. They made agreements with the people they exhibited
that defined working hours, salary, duties and medical checks. Some individuals from
colonies actually took the opportunity to participate in shows in Europe voluntarily and
willingly in order to receive money
- although they were not paid more than a fraction of the total income from the
shows they participated in
- Another task of impresarios was to inform about their shows as large public as possible.
As Bogdan writes, Display of non-Westerners in freak shows was not intended as a
cross-cultural experience to provide patrons with real knowledge of the ways of life and
thinking of a foreign group of people. Rather, it was a money-making activity that
prospered by embellishing exhibits with exaggerated, bogus presentations emphasizing
their strange customs and beliefs. Showmen took people who were culturally and
ancestrally non Western and made them into freaks by casting them as bizarre and
exotic: cannibals, savages, and barbarians
- main advertising campaign started by choosing an exciting title, e.g. Wild African
Savage or Amazon Corps that was complemented with a corresponding illustration in a
poster or billboard.
- Visitors of the shows could buy souvenirs, posters, illustrated postcards, photographs,
leaflets or the above mentioned pamphlets with a CV of the freaks exhibited
- If researchers confirmed authenticity of the show, organizers could refer to it as an
educational programme and thus did not have to pay amusement tax that would
otherwise be up to 40% of the gross income.
- various cheaters who sponged on shows, especially people such as circus
entrepreneurs who enriched themselves through mystification.
- As a consequence, they distorted the origins of freaks, imitated other performances or
claimed that live exhibits participated in world shows
- Holding freak shows along with quasi scientific and educational programmes focused on
exchange between the emerging disciplines of the time and on popular culture.
- Phineas Taylor Barnum (1810– 1891): U.S. impresario, introduced A new concept of
freak shows. In the 1830s, he presented his first freak show which consisted in
displaying a presumably 160 year old and blind former nurse of George Washington.
From 1842 he ran Barnum's American Museum in New York. Before the museum was
destroyed by fire in 1865, it was visited by approximately 38 million visitors. In addition to
exotic animals, wax figures and jugglers, Barnum also presented freak shows with
Albinos, Lilliputians, giants, bearded women or Siamese twins. A significant person of
 the freak show was Charles Sherwood Stratton (1838–1881), a boy of a small stature
who performed under the nickname General Tom Thumb. Barnum taught Stratton to
sing, dance, tell jokes in rhymes, do pantomime and imitate various historic or
mythological persons such as Cupid, Samson, Hercules, Napoleon Bonaparte or
Robinson Crusoe (Kirk 1972: 25). In 1844–1847 they went on a tour in Europe where
they visited the royal court of the British Queen Victoria, Queen Isabel II of Spain,
Russian Tsar Nicolas I in St. Petersburg and Royal Palace of Louis-Philippe of France.
In 1863, Barnum arranged a wedding of Stratton with a dwarf girl called Lavinia Warren.
News of the stage-managed dwarf wedding appeared in many newspapers, spread over
the Atlantic and soon became an example that was followed in Europe and the U.S. until
the middle of the 20th century.
- according to which shows "depended on a supply of curiosities from abroad, which in
turn provided racial theorists with new "specimens" to analyze. (in the case of the Azetec
twins: bought when they were children in San Miguel in Salvador for presentation
purposes, in order to achieve more publicity a rumour was circulated that they were
found in a lost MesoAmerican town of Iximaya)
- Maximo and Bartola were regarded not only as the last living descendants of the
Aztecs, but also as members of a worshipped clerical caste, which means they
were promoted to a subject of religious worshipping. Their different social status
and ethnicity were used commercially by exhibitors and impresarios
- "They do not appeal to the public as dwarfs, hunchbacks, Tom Thumbs, Siamese
Twins or other distorted curiosities: but belong to another category. While to a
European public they are sui generis they are placed before the public as
exemplars of a race of people hitherto unknown – a race unlike in form and
feature all the modern inhabitants of the earth"
- Owing to their unusual physiology, it was also considered that they could be
affected by microcephaly that is demonstrated by an abnormally small head and
insufficiently developed brain
- Racial characterizations were then funneled back into the materials purveyed by freak
show promoters, lending them an air of respectability and further securing scientific to
mass culture.
- Barnum considered Zip (a black man with a conic head) to be a living example of the
missing element between the man and the ape.
- Carl Hagenbeck (1844–1913): German impresario and trader. great success at
Hagenbeck's zoological garden in Hamburg. Hagenbeck also intensified and opened the
cooperation between impresarios and scientists, especially Berlin Society for
Anthropology, Ethnology, and Prehistory founded in 1869. Its co-founder, long-time
chairman, physician and physical anthropologist Rudolf Virchow recommended that
participants in the shows of indigenous people are studied. Virchow performed
anthropometric measurements of indigenous people, especially of the Inuits and Bella
Coola or Tehuelche tribes at Hagenbeck's shows.
- Hagenbeck also organized a tour of shows of indigenous people in Germany and
Europe and in 1880
 - Hagenbeck based his shows of indigenous people on accentuating the context of
their authentic geographic environment including their homes, animals, plants,
weapons, tools and other ethnographic artefacts.
- sent his agent, the Norwegian ethnologist Johan Adrian Jacobsen to the various
parts of the world In order to get people from Africa, the Arctic, India and Sri
Lanka and Southeast Asia
- Between 1874 and 1913, Hagenbeck organized in total 54 shows of indigenous
people. However, not all of them were based on juxtaposition of people and
animals.
- Hagenbeck is considered to be a pioneer of modern zoological gardens where he
tried to create conditions for animals that would be as similar as possible to their
original environments.
- In 1907 he opened in Stellingen in Hamburg Tierpark Hagenbeck (still exists
today), the first zoological garden where he applied a new principle of no bars by
using simple natural barriers such as trenches, rocks and water reservoirs.

- Albert Geoffroy Saint-Hilaire (1835–1919)

- Became director of Hagenbeck’s Nubian show In 1865(which went to the Jardin
zoologique d'acclimatation in Paris in 1877 and 1879. It was a zoological garden
that was inaugurated in 1860 by the French Emperor Napoleon III)
- in 1877 he included freak shows in the programme
- The exhibition of Nubians consisted of fourteen Africans and animals from
Somalia and Sudan such as dromedaries, elephants, giraffes, rhinoceros and
ostriches. Sow was an immediate success, opened new opportunities to Jardin
d'acclimatation that was experiencing financial trouble after the Franco-Prussian
War and Paris Commune
- under the management of the French anthropologist Paul Broca (1824–1880),
visited the shows several times and they did not only focus on the skull
morphology (craniometry and frenology), but also on human anatomy of "live
species". They published their scientific conclusions in the press and contributed
to the general public acclaiming the freak shows.
- However, in the 1880s more and more reproaches appeared in the public
claiming that the indigenous people in the shows did not correspond to travellers'
reports and ethnographic descriptions of their cultures. Indigenous people in the
Jardin d'acclimatation were actually civilized, which was due to their contact with
the West. Other reproaches concerned the "natural" environment that did not
include all ethnologic artefacts. Through the shows, indigenous people became
"savage animals" rather than natural savages
- Legacy and Decline of Freak Shows
- What formed freak shows and exhibitions of human curiosities was imperial
colonialism, culminating in the 1870s.
- Colonial expansion of the West contributed to the development of anthropology
and ethnology that were involved in scientific reflection and in forming of a picture
of non-European native nations and cultures.
- The imperial context of geopolitical, scientific and economic expansion made
freak shows a relatively available means of entertainment.
- A role was also played by a wider consumerism spreading in the middle
and lower working class that determined the perspective through which
the exhibited human subjects were seen. The public often did not realize
that exhibition of the culture of indigenous people was not authentic.
- Many physical atavistic stigmas and recessive features of human freaks used
and accentuated by impresarios with the view of making more profit contributed
to the fact that the status of the individuals exhibited decreased their humanity
and Barbora Půtová 100 FIGURE 8: Ota Benga at the Bronx Zoo. Photo, 1906.
The Library of Congress, Washington, D.C. drew them inhumanely into the world
of animals.
- Physical abnormalities, corporal oddities and other exotic features were
not only biologically innate, but also culturally formed
- The cultural category of freak shows is historically, ideologically and socially
determined and grounded in Eurocentric cultural norms and values
- Every oddity and otherness of the body presented in freak shows became a
subject that was visually consumed, which decreased the authenticity and
humanity of the person exhibited.
- On the background of the shows, performances and exhibitions making use of
drama, accentuated through props, costumes and narration of otherness and
exoticism, a visually digestible, impressive and seemingly plausible construction
of a culturally or physically different individual was created
- The emphasis on abnormality, otherness and exoticism together with the
preference of physically disfigured people – subject of the shows and
performances – destabilized the traditional normative approach to the human
body
- a new concept of a normal body defined as an average body arose In the
second half of the 19th century, The presumably neutral concept of the normal
was an ideological construct represented by the bourgeoisie. Mediocrity was
defined as a moral ideal and it was supported by the middle class.
- A normative body was, with its proportions, measurable, classifiable and
relatively stable
- freak shows presented a different body that was formed, interpreted and
reproduced in the context of unequal power relations. Therefore, the manner in
which human curiosities were presented meant that different bodies were in
contrast to everyday reality
- The physically disabled body became "a repository for social anxieties
about such troubling concerns as vulnerability, control, and identity"
 - It was a projection area stemming from the power position of the Western
man reflecting his fears, fantasies or doubts about the categories of
normality and normal identity. That is why some bodies from this
hierarchy are perceived "as ugly, disgusting, or degenerate"
- Freak shows often intentionally accentuated the dimension of ugly,
different, abnormal or otherwise bizarre bodies that were regarded from
the superior power perspective.
- Until the First World War, freak shows were a sought-after form of entertainment
- Just as Saartjie Baartman anticipated and symbolized the nascence of these
shows, their extinction was heralded by Ota Benga (1883–1916). This member of
the Pygmy tribe of Batwa was first presented in a zoological garden in Bronx in
1906 in a cage in the chimpanzee and orangutan pavilion. After he left the
garden he learnt English and worked in a cigarette factory in Lynchburg. Since he
could not return to Congo due to the First World War, he suffered from
depressions and committed a suicide in 1916
- Recession of freak shows occurred in the post-war period when they started
gradually disappearing from the European entertainment scene. At the same
time, Nazism was growing in importance and it refused immigration of the
foreigners who appeared in the shows.
- After the Second World War, freak shows could only be seen sporadically as
traditional popular entertainment found itself suddenly in competition with the
movie industry
- The development of international tourism in the 1950s then led to their total
extinction as indigenous people could be visited and admired in their home
countries in the context of their native culture and everyday life

The Normal Body reading notes

- “Normality” and “Abnormality” in health and human bodies
- The idea/standard of normal is understood as the normative (acceptable norm) and we
subconsciously equate that standard as related to not only a person’s physical
conditions, but also moral right-ness/worthiness. It creates a standard that suggests
where/how individuals are “ought to be”, yet this value/standard (meeting point on the
scale) is determined by an mathematical average number of a number of different states.
Fundamental tension between normal and moral is largely unexamined, biology has
come to furnish the standard by which different is managed, using statistical techniques
that distinguish between the normal and pathological
- The whole process, encompassing changes that took place as part of European
modernization, was characterized by Max Weber as ‘the disenchantment of the world’.1
A further crucial development came about when apparent bodily variation began to be
defined in terms of deviation from a statistical norm or average.
- Norm and normal, the statistical and the moral, became conflated in this understanding
of variation as deviations. Individual bodies were ‘normalized’ both biologically and
statistically.
- Once the material characteristics of individual bodies were described and
quantified, they were then assessed against ‘normal’ values established by
statistical surveys of ‘healthy’ populations. I.e. blood tests
- What counts as ‘normal’ in actuality is a statistical average.​
- the idea of normal is understood as normative (what it takes to be healthy), and is also
very often equated with what is morally right (the range where individuals ‘ought’ to be).
- The fundamental tension between the normal and the moral remains largely
unexamined to this day. Biology alone has come to furnish the standard by which
difference is managed, using statistical techniques that distinguish between the
‘normal’ and the ‘pathological’.
- The work of human standardization by means of biology is an essential step that
enables the global circulation of biomedical technologies including
techno/biologicals, body parts, and ‘normalized’ ideas of personhood
- Case of Cholera in the 19th century
- Before objects and events can be discerned as perceptible phenomena, their
very existence has to be recognized by a process of naming, ordering and
classification. Such recognition, including the diagnosis and management of
episodes of illness, is the product of culture and does not emerge spontaneously
from nature
- what counts as disease and illness is the result of particular practices embedded
in specific historical, political, social and technical relationships
- Steven Johnson in his book The Ghost Map4 illustrates how it was extraordinarily
difficult for both the medical authorities and policymakers of the mid-nineteenth
century to recognize the water supply as the source of the disease Cholera
- This was the case even when Dr John Snow presented them with what can justly
be accepted as sound scientific evidence by current standards. Prior to the
mid-nineteenth century it was believed that this deadly condition was caused by
‘miasma’​ – noxious emanations that resulted from the foul conditions and putrid
stench perpetually present in incredibly densely populated cities such as London
before sanitary facilities had been installed
- Snow was confronted with the cholera epidemic of 1832 that killed 32,000 people
across the country before suddenly, inexplicably, petering out. While an
apprentice doctor in a mining area in northeast England. It seems that Snow
never forgot this experience5 and after he had set up practice in London, when
cholera returned in 1848 he immersed himself once again in caring for patients
struck down by the epidemic, all the while paying careful attention to who exactly
contracted the disease and who was spared. He noted that it was not only the
poor living in fetid and crowded surroundings who died, but also at times people
of the middle class. Snow began to be sceptical of the miasma theory, and
insisted that the disease so rapidly killing hundreds of people in central London
 must be caused by water, because only as a result of imbibing tainted water
could so many people die who were not usually in direct contact with one another
- Gradually a handful of doctors began to accept Snow’s theories, but for the most
part, despite publications, he was ignored. When the next epidemic struck in
1854, Snow decided to systematically compare the experiences of people who
drank water from two different water sources, one polluted by London sewage
and the other, further upstream, unpolluted. He was about to publish his findings,
which clearly demonstrated a stark difference in incidence of cholera cases
depending upon a given water source, when the most swift and deadly attack of
cholera ever recorded in London broke out in Soho, very close to where Snow
himself was living.
- Snow used a new tool of his day, ​‘disease mapping​’, in which he reproduced a
street plan and marked the deaths from cholera house by house on the map,
from which a clear pattern of infection started to emerge. Snow then interviewed
selected people, both on the streets and in their homes, asking them, above all
else, about the sources of their water. By supplementing the findings obtained by
disease mapping with this ethnographic approach, slowly, and with great
persistence, Snow was able to establish that every one of the dead and dying in
the area he had surveyed had imbibed water drawn from the same public source
– the Broad Street pump. It also became clear that in this limited geographical
area, several small, discrete pockets were left unaffected by the epidemic, one of
which was the Lion Brewery, where no workers were struck down at all. It soon
became evident that they drank only beer. With great reluctance, officials agreed
to take the handle off the pump at Snow’s insistence, although this did not bring
about an abrupt end to cholera because the disease had already moved on6 and
most officials remained wedded to a miasmic theory of causation.
- Henry Whitehead
- support Snow’s position after carrying out his own investigations in his
impoverished parish and its environs. It was he who inadvertently detected the
‘index case’, when he talked to a mother who had disposed of her infant’s
cholera-infected diapers, while the child was still alive, into a cesspool encased
by rotten bricks that leaked faecal matter into the well that supplied the Broad
Street pump. Even so, the powerful physicians who sat on the Board of Health
continued to dismiss Snow’s findings as unsound, as did the prestigious journal
The Lancet, largely because his findings went against the dominant medical
theories of the day that attributed epidemics to miasmas.
- after Snow’s death, when the next scourge of cholera hit the city causing over
4,000 deaths, that members of the Board of Health, ‘blinded’ until that time by
their belief in miasmas, grudgingly acknowledged that the disease was indeed
waterborne, and that the poor did not succumb most readily to the disease
because of the ‘filth’ they themselves created, as the board had earlier declared.
Eventually Snow was given due credit for his research that could no longer be
 disregarded once the Vibrio cholerae (the bacteria that causes cholera) was
recognized.
- Filippo Pacini
- Italian scientist. isolated the Vibrio cholerae in 1854 when bacteriological
techniques were first being developed.
- finding went unnoticed for several years, and Robert Koch, the German scientist
who had earlier isolated the tuberculosis bacillus, was given credit for the
discovery.
- After the existence of the bacilli had been incontrovertibly demonstrated, strong
claims began to be made about necessary causal factors contributing to specific
disease states. This new approach to disease aetiology opened the door to the
idea of universal causation and fostered a reductionist approach to the
understanding of disease aetiology. Louis Pasteur’s contribution, very important
in this transformation
- evidence for the germ theory of disease causation contributed greatly to the recognition
of European medicine of the day as a science, leading people to assume that what were
thought of as the superstitions and beliefs of previous generations of medical
professionals would soon be a thing of the past.
- The increasingly rational, systematic approach to the accumulation of medical
knowledge and its application that ensued from the latter half of the nineteenth century in
which knowledge about infectious disease had a singularly important role, has granted
biomedicine therapeutic efficacy over a broad range of conditions.
- this account shows, however, Snow was able to control a major epidemic even before
the discovery of Vibrio cholerae; only after this discovery did germ theory gain
widespread acceptance. Moreover, it makes clear that unquestioned assumptions and
truth claims embedded in medical knowledge and practice of all kinds should be put into
historical perspective – something to which we now turn
- Representing the Natural Order
- In common with all other forms of medical knowledge, the orientation and
practices of biomedicine as we know it today are a product of a particular
historical, political and social context that informs the way in which the natural
order, including the human body, is represented and worked upon.
- historians Lorraine Daston and Katherine Park argue that for a period of about
two centuries immediately prior to the Enlightenment it was assumed that wonder
and passion were most effective in bringing about an understanding of nature.
- The time was marked by stories of ‘wondrous therapeutics’ and an explosion of
professional medical services in the marketplaces of recently urbanized areas.
These therapies were unique and this made them particularly attractive.
- Several fundamental changes gathered momentum towards the end of the
seventeenth century in Europe, resulting eventually in a radically different
understanding of the natural order, one dependent for the first time upon the
positing of uniform and inviolable laws.
 - Wonders continued to happen occasionally, but they could no longer lay claim to
any special ontological status outside ‘the strictly natural’.9 They became
marginalized, lying at the boundaries of established scientific knowledge, either
dismissed as nonsense or else scientifically examined to establish their possible
worth. Numerous techniques and therapies that come under the umbrella of what
is today called ‘complementary medicine’ fall into a similar marginal position.
- Truth to Nature
- This approach in the eighteenth century ​called for recognition of scientific
knowledge and practices that could only arise in ​what Lorraine Daston has
termed a ​‘specific moral economy​’​ that​ she argues​ is inevitably associated with
the production of scientific knowledge.
- Daston notes that​ this moral economy embodies an ideal of scientific objectivity
that insists on ‘the existence and impenetrability’ of boundaries between facts
and values, between emotions and rationalit​ y
- By ‘moral economy’ Daston does not mean that ideologies and political
self-interest inevitably penetrate the scientific endeavour (although often they
clearly do). Nor is she suggesting that scientific knowledge is socially
constructed, and can, therefore, simply be equated with other kinds of knowledge
as a belief system. In using the concept of moral economy Daston implies ‘a web
of affect-saturated values that stand and function in a well-defined relationship to
one another’.12 She points out that even though moral economies of science
‘draw routinely and liberally upon the values and affects of ambient culture, the
rewording that results usually becomes the peculiar property of scientists
- Daston is writing about ‘truth’ claims made in connection with objectivity,
measurement, replication, and so on, and also about the sciences of probability
and the ‘making up’ of populations designated at risk.
- Theodore Porter notes that the ability to attain consensus allows a specialist
disciplinary community to reach tacit agreement that its work is objective.15 He
adds: ‘its acceptability to those outside a discipline depends on certain
presumptions, that are rarely articulated except under severe challenge’.
Specialists must appear, therefore, to be disinterested in what they do, that is, in
contrast to medieval times, to work without passion.16 In a related vein, when
discussing ‘modernist sensibilities’, Christopher Lawrence and Steven Shapin
argue that, after Descartes, knowledge was, in theory, disassociated from value:
‘knowledge itself’ came to inhabit a ‘transcendental and disembodied domain’.
- Daston and Peter Galison have co-authored a book titled, simply, Objectivity,
which argues that the history of the idea of scientific objectivity, when examined
closely, is surprisingly short, commencing only in the mid-nineteenth century.
They set out to write this history with an emphasis on ‘​epistemic virtue​’, that is,
the ​choices that are made and techniques that are used in order to comprehend
nature, in order to divide it into what are assumed to be fundamental,
standardized, working objects​. ​Epistemic virtue​,​ designed to know the world
 and not the self, not only subsumes what is thought to be truthful and objective
but also embodies certainty, precision and replicability.
- distinction between ‘moral economy’ and ‘epistemic virtue’:​ epistemic virtues as
parts of (not substitutes for) moral economies’​ . An epistemic virtue of objectivity,
then, is just one part of a larger moral economy of science that also favours other
practices, including standardization and rule-bound procedures that are clearly
defined and firmly enforced. What specific epistemic virtues and broader moral
economies have in common is a fusion of ethical and epistemological elements.
- use of atlases, which were employed across a range of scientific disciplines from
astronomy to medicine - the struggle to represent nature takes three distinct turns
from the mid-eighteenth century on – three forms of epistemic virtue that they call
‘truth-to-nature’, ‘mechanical objectivity’ and ‘trained judgment’.​
- no simple progression from one form of representation to another takes
place; instead, the repertoire of epistemic virtues expands, with each
redefining and informing the others, rather than transcending them.
- Epistemic virtues earn their right to be called virtues by moulding the self, and the
ways they do so parallel and overlap with the ways epistemology is translated
into science
- work of Carl Linnaeus exemplifies the truth-to-nature orientation – his method of
classifying plants was ‘openly and aggressively selective’.20 His was an era of
obsessive collecting of natural objects, closely associated with the early days of
exploration and the founding of colonies, but the objective was to identify and
depict only ideal types and to cast out everything thought to exhibit an anomaly.
Scientists in Linnaeus’s time attempted to control the activity of illustrators who
depicted objects found in nature so that only ‘truthful’ representations were
created.
-