NEWSLETTER

Society for the History of Children and Youth

Child Health and Medicine at the SHCY Conference

Kathleen W. Jones, Virginia Tech

Experiences of illness, medical care and treatment, and norms for child health, mental and physical, are subjects that combine many of the questions posed by the history of children and youth.  The significance of these subjects was amply represented in the papers presented at the 2007 SHCY conference. 

The session “Child Health and Medicine, 18^th century to the 1930s” featured papers by three scholars, Alysa Levene, Lisa Grant, and Anna-Karin Frih, that addressed the various ways children were incorporated into medical institutions and medical discourse.  In “Children and Hospitals before Children’s Hospitals: Eighteenth-Century Institutional Care for the Young Sick in Provincial England,” Levene argues that despite regulations that prohibited admission of children, children were admitted and treated.  Hospital care, she concluded, played a greater role in child care in the 18^th century than historians have previously thought.  However, this finding did not suggest a pediatric specialization rather children and adults received similar treatment.  The hospital, Levene suggested, had not caught up with the sensitivity to pediatric care in 18^th-century medical literature. In “Institutions and Innovations: The Development of Paediatrics in England and France, 1830-1894, Grant discusses the process of medical specialization.  By comparing both medical education and specialized medical institutions in 19^th century England and France, Grant concluded that pediatrics was a specialty before the end of the century when “pediatrics” had a name.   Frih’s paper, “The Girls are Sick, Week and Over Strained: Sickness amongst Girls and Boys in Swedish Physical Examinations, 1870-1930,”  argued that prior to 1900 the poor health of Swedish girls was a popular medical topic, but after 1900, popular and scientific medical discourse verged.  While physicians continued to be obsessed by the poor health of girls, in popular discourse, the healthy girl was the more widely described figure.  Mona Gleason’s comments on this session pointed to the tension between the history of childhood and the history of children.  She noted that the child patient was both central and incidental to all three essays, and wondered what would happen if the authors included children as well as ideas about children in their papers.  How, Gleason asked, might the inclusion of children contribute to theorizing about age as a category?

In the session titled “Children and Health” Heloise Helena Pimenta Rocha discussed school medical inspection in Sao Paulo, Brazil in the early twentieth century.  Rocha argues that racial regulation was the goal of the school inspectors and that, as they fit children in categories of physical normality and abnormality the doctors’ goal was the “regeneration of the Brazilian race.”  Rosa Ballester and Maria Isabel Porras presented “Child Protection as a Political Resource: The Influence of International Agency Advice on Sanitary Campaigns against Poliomyelitis in Spain (1940-1975).” They described the initial mistrust among Spanish officials toward the international campaign promoting polio vaccination followed by a government sponsored immunization campaign in in 1963-1964 associated with authoritarian political efforts at modernization.  The results of this first effort were, the authors report, “excellent,” but in the transition to democracy during the 1970s, the campaign stagnated.  The authors concluded the presentation by showing a brief public health video on administering the polio vaccine.  Diego Armus reported that the paper, “Discourses and Experiences in the Shaping Process of Healthy Children: Soccer, Physical Education, and Tuberculosis in Buenos Aires (Argentina), 1900-1950,” was part of research for a history of TB.  TB was not a children’s disease, the author concluded, but children had a significant place in the discourse.  Concerns about the future of the nation led to interest in the 1930s in the “pre-tubercular child,” an emphasis on prevention, and a growing interest in a form of physical education that highlighted character building as well as physical health.  But, the contrast between discourse and practice emerged as the author described oral histories with male students (who preferred playing soccer to character building experiences).   In her comments Marie Clark Nelson pointed out that the papers raised the question:  “the healthy body, for whom?”  and noted that this session, and others at the conference, begged for a comparative framework.

Finally, the history of child guidance and child mental health was well represented in two sessions .  John Stewart,  Kari Ludwigsen, and Karin Zetterqvist Nelson presented papers in a session titled “The History of Child Guidance: A Comparative International Perspective.”  John Stewart related the origins of child guidance in Britain (“’The Dangerous Age of Childhood’: Child Guidance in Inter-War Britain”) concluding that as it crossed the Atlantic, child guidance (an American invention for the dealing with juvenile misconduct) underwent some transformations in form and function as it became an established part of the British health system.  “What does this tell us?” about childhood in the interwar years, Stewart asked and concludes that child guidance exemplified the shift in the early twentieth century from focus on the child’s body to focus on the mind, and the history of child guidance highlights the pathologizing of normal childhood.  Kari Ludwigsen examined handbooks, textbooks, and government reports to trace changing concepts of healthy childhood in Norway and the meaning of “prevention.”  Ludwigsen found that by the early 1970s in Norway’s mother and child health centers mental health issues had replaced nutrition as the subject of expert concern.   Karin Zetterqvist Nelson examined “The Development of Swedish Child Psychiatry,” 1945-2000, asking how the dominance of the psychodynamic approach was achieved.  She traced the influence of two socialist physicians who helped to integrate child psychiatry into the modern welfare state.  In her comments Sibylle Brändli Blumenbach pointed to the significance of the “post-war moment” when interest in mental hygiene shifted from the local to the national policy level, to the need for comparative work on the pathologizing of normal childhood, to the gender politics inherent in child guidance history, and to the methodological question – should historians examine the theories behind the mental health institutions or the practice?

Brändli Blumenbach was then joined by Dirk Schumann on a panel titled “Children in Trouble, Experts in Conflict: Professional Help in the Second Half of the Twentieth Century.”  In her paper,  “Healthy, Wealthy and Wise? Psychological Professions, the Affluent Society and the Perils of Children’s Mental Health (Switzerland, 1960s-1980s)," she uses the concept of "intimacy" to examine changes in school psychology that resulted in the growth of counseling as well as diagnostic services.  Schumann, too discussed school psychology in the second half of the twentieth century.  In “Experts on the Margins: School Psychology in Germany from the 1950s to the 1970s," he suggested that school psychologists occupied a marginal position in the post-war German school system.  Their goal of becoming "systemic" advisers on the structuring of schooling failed, although they were able to establish the profession as one of individual counseling for troublesome children and their parents.

In my own session on the “Historical Significance of the Child Developmentalists” Emily D. Cahan described a little-known utopian novel written by the child study expert, G. Stanley Hall.  Hall drew on his sentimental ideas about adolescence to construct the values of his utopia.  My paper, “’Monstrous and Unnatural’: Child Suicide in the Late Nineteenth Century,” argues moral statisticians and psychiatrists pulled from Victorian ideas about childhood to construct a separate category of “child” suicide and explain why children were led to complete acts of self-destruction.

Ideas about childhood and expert interpretations of child health dominated these discussions.  As commenters pointed out, children, the subject of the expertise, are incidental in these presentations. But, can we have a complete picture of the history of child health until we look at health as the child saw it?   How did children experience sickness; how did they understand death and dying?  And, how can we research these elusive topics?  Perhaps these are questions to be addressed by participants in the next conference of the Society for the History of Children and Youth.