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4 Middle-class medicine It is well known that Englishmen are in the main opposed to any and every new system with which they are not familiar. Probably to this influence is due the fact, that, with a few exceptions, pay wards are as unknown in this country as the pay hospitals themselves. 1 Sir Henry Burdett
This book is a history of nineteenth-century Dublin through human–animal relationships. The book offers a unique perspective on ordinary life in the Irish metropolis during a century of significant change and reform. The book argues that the exploitation of animals formed a key component of urban change, from municipal reform to class formation to the expansion of public health and policing. The book uses a social history approach but draws on a range of new and underused sources including archives of the humane society and the Zoological Society, popular songs, visual ephemera and diaries. The book moves chronologically from 1830 to 1900 with each chapter focused on specific animals and their relationship to urban changes. The first chapter examines the impact of Catholic emancipation and rising Catholic nationalism on the Zoological Society and the humane movement. The second chapter looks at how the Great Famine drove reformers to try to clearly separate the urban poor from animals. The third chapter considers the impact of the expanding cattle trade on the geography, infrastructure and living conditions of the city. The fourth chapter looks at how middle-class ideas about the control of animals entered the legal code and changed where and how pigs and dogs were kept in the city. The fifth and final chapter compares ideas of the city as modern or declining and how contrasting visions were associated with particular animals. The book will interest anyone fascinated by the history of cities, the history of Dublin or the history of Ireland.
This book examines the payment systems operating in British hospitals before the National Health Service (NHS). An overview of the British situation is given, locating the hospitals within both the domestic social and political context, before taking a wider international view. The book sets up the city of Bristol as a case study to explore the operation and meaning of hospital payments on the ground. The foundation of Bristol's historic wealth, and consequent philanthropic dynamism, was trade. The historic prominence of philanthropic associations in Bristol was acknowledged in a Ministry of Health report on the city in the 1930s. The distinctions in payment served to reinforce the differential class relations at the core of philanthropy. The act of payment heightens and diminishes the significance of 1948 as a watershed in the history of British healthcare. The book places the hospitals firmly within the local networks of care, charity and public services, shaped by the economics and politics of a wealthy southern city. It reflects the distinction drawn between and separation of working-class and middle-class patients as a defining characteristic of the system that emerged over the early twentieth century. The rhetorical and political strategies adopted by advocates of private provision were based on the premise that middle-class patients needed to be brought in to a revised notion of the sick poor. The book examines why the voluntary sector and wider mixed economies of healthcare, welfare and public services should be so well developed in Bristol.
Early and mid-Victorian social reformers were optimistic regarding the middle classes’ ability to steer Britain towards a more prosperous future. 1 Social action, sanitary reforms and medical science could be deployed to improve the condition of the working classes and cure their ills. 2 However, the incurable, those whose disorders medical practitioners deemed refractory to treatment, presented a challenging barrier to this idealism and
charity, even as these underwent significant changes over the early twentieth century. The previous two chapters examined the arrival in the hospital of patient payments and the almoner, contributory schemes and the middle-class patient, and how they became commonplace in the interwar years. It is typically assumed that these changes undermined or even ended philanthropy as the organising principle of the voluntary hospitals. 1 Yet, as we have already seen
fellow’. 4 Meanwhile, the surgeon was ‘interested’ in George, who was ‘so obviously middle class. And he guessed he must have been pretty low’ for his doctor to have sent him there. As a poor patient of middle-class character, the surgeon knew ‘Anderson would get the same skill – if not the same nursing – for nothing.’ He explained the medical details ‘to the students who, recognising Anderson as one of their own class, felt slightly
enforcer of middle-class values. The story of dogs and pigs also shows how middle-class Dubliners sought to resolve the human dilemma created by conflicting desires. On the one hand, they wanted to keep dogs and eat pork. On the other hand, they wanted to reduce the urban nuisances created by dogs and pigs. The solution was to regulate animal-keeping, changing who could own a pig or a dog in Dublin. Such regulations represent a form of governmentality: they sought to cement ideas of acceptable urban street life. 6 They also demonstrate the ways in which regulation of
wealthy southern city. The options, obligations and experiences of Charley are considered in chapter 3 and then those of George in chapter 4 ; with particular attention to how the hospital payment schemes they would have navigated were introduced in our case study city. Treating the two in separate chapters reflects the distinction drawn between and separation of working-class and middle-class patients as a defining characteristic of the system that emerged over the early
training courses, actors in both the medical and sporting spheres were still able to identify some practices as novel or innovative, others as old-fashioned or traditional, and yet more as scientific or mere quackery. What this chapter will go on to show is that both philosophical and physiological theories constrained and informed the construction of sports medicine; these ideas were part of the shared values and liberal education of a generation of middle-class men who, as doctors or amateur athletes, contributed to an understanding of the athletic body in the early
predominantly a middle-class, whitecentric narrative written from the privileged position of the global north. The so-called ‘medicalisation’ of birth has been, from its inception, a class- and race-based project and has never applied equally to all women (Oparah and Bonaparte, 2015 ). For example, the preference for male birth attendants first began to surface among middle- and upper-class women in Europe during the 1750s (Shorter, 1982 ). The ability to procure a male midwife was regarded as a ‘fashion statement’ (Hanson, 2004 ) and a sign of high status (Shorter, 1982