BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who (...) struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

The Hippocratic texts and other contemporary medical sources have often been overlooked in discussions of ancient psychology. They have been considered to be more mechanical and less detailed than poetic and philosophical representations, as well as later medical texts such as those of Galen. This book does justice to these early medical accounts by demonstrating their richness and sophistication, their many connections with other contemporary cultural products and the indebtedness of later medicine to their observations. In addition, it reads these (...) sources not only as archaeological documents but also in the light of methodological discussions that are fundamental to the histories of psychiatry and psychology. As a result of this approach, the book will be important for scholars of these disciplines as well as those of Greek literature and philosophy, strongly advocating the relevance of ancient ideas to modern debates. (shrink)

Since the establishment of the modern prison system in the early nineteenth century, prisons and prisoners have been construed as sites of moral, social, and biological contagion. Historic and contemporary studies show that most prisoners experience severe health inequalities, higher rates of addiction and mental health issues, and lower life expectancy than the rest of the population. They also come from deprived social strata. Yet, these aspects of Irish penal history have been largely neglected in academia and (...) popular histories. Our article discusses two public history projects—an art installation, _The Trial_, and a museum exhibition, _Living Inside_—that engaged different publics with the long history of health and welfare in Irish prisons. Developed by the research team on the Wellcome Trust Investigator Award “Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000,” based at University College Dublin, the projects adopted different methodologies to engage their audiences and explore the experience and management of health and welfare in nineteenth- and twentieth-century Irish prisons. We further examine the different methodological approaches of each project, their varied aims and audiences, and the impacts reported by audiences and participants. The article also considers some of the challenges of doing this kind of public history, both in terms of working with marginalized communities and presenting research about difficult subjects to various audiences. (shrink)

ABSTRACT The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness to (...) transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health. (shrink)

Many scholars have historicized biopolitics with reference to the emergence of sovereign nations and their colonial extensions over the 18th, 19th and 20th centuries. This article begins to conceptualize and trace the history of biopolitics beyond the nation, arguing that the history of world health - the great 20th-century reach of 19th-century health and hygiene - should be understood as a vital politics of population on a newly large field of play. This substantive history of (...) world health and world population is analysed as sites for thinking about global bio-politics; and the article looks seriously at the interwar period as a point at which ‘the world’ (or Hardt and Negri’s ‘Empire’) was already challenging the idea of ‘inter/national’. (shrink)

This book has been defined around three important issues: the first sheds light on how people, in various philosophical, religious, and political contexts, understand the natural environment, and how the relationship between the environment and the body is perceived; the second focuses on the perceptions that a particular natural environment is good or bad for human health and examines the reasons behind such characterizations ; the third examines the promotion, in history, of specific practices to take advantage of (...) the health benefits, or avoid the harm, caused by certain environments and also efforts made to change environments supposed to be harmful to human health. The feeling and/or the observation that the natural environment can have effects on human health have been, and are still commonly shared throughout the world. This led us to raise the issue of the links observed and believed to exist between human beings and the natural environment in a broad chronological and geographical framework. In this investigation, we bring the reader from ancient and late imperial China to the medieval Arab world up to medieval, modern, and contemporary Europe. This book does not examine these relationships through the prism of the knowledge of our modern contemporary European experience, which, still too often, leads to the feeling of totally different worlds. Rather, it questions protagonists who, in different times and in different places, have reflected, on their own terms, on the links between environment and health and tries to obtain a better understanding of why these links took the form they did in these precise contexts. This book targets an academic readership as well as an “informed audience”, for whom present issues of environment and health can be nourished by the reflections of the past. (shrink)

With the increased acceptance of complementary and alternative medicine (CAM) within society, new research reflects deeper folk health histories beyond formal medical spaces. The contested relationships between formal and informal medicine have deep provenance and as scientific medicine began to professionalise in the 19th century, lay health knowledges were simultaneously absorbed and disempowered (Porter 1997). In particular, the ‘medical gaze’ and the responses of informal medicine to this gaze were framed around themes of power, regulation, authenticity and narrative (...) reputation. These responses were emplaced and mobile; enacted within multiple settings by multiple agents and structures over time. The work is drawn from secondary material from Ireland, which identify more indigenous narratives of health and act as potential sources for medical humanities. While assumptions have been made as to the place of folk-medicine being essentially rural, evidence will be presented which shows a more complex network of health beliefs and practices. The narratives of informal practice and folk-medicine drawn from evidence from Ireland point to more fluid and hybrid relations with formal medicine and suggest that the complementary nature of the two models reflected wider cultural debates and models of belief (Del Casino Jnr., Health & Place 10:59-73, 2004). (shrink)

Created in 1980, the Health Effects Institute funds research relevant to air quality policy debates and performs other tasks at the boundary between the health effects research community and the air quality policy community. In a 1993 review, the HEI was harshly criticized for a lack of relevance and timeliness in its research products and for poor relationships with its sponsors. Since the review, the HEI has undergone a series of changes that have strengthened its position as a (...) central and respected institution in both the health effects research and air quality policy communities. The apparent success of these recent changes suggests a number of lessons that can be learned about the function of boundary organizations, which bridge the worlds of science and governance. In particular, the HEI’s recent history demonstrates the importance of effective leadership and the importance of maintaining independence without resorting to isolation. (shrink)

The Health Humanities Consortium was established in 2015 to “promote health humanities scholarship, education, and practice through transdisciplinary methods and theories that focus on the intersection of the arts and humanities, health, illness, and healthcare.” As the founding co-chairs of the HHC, we provide a history of the founding of this organization in this article, describing the journey of its creation, the choices and challenges it faced as a new organization, and our hopes for a rich (...) future. (shrink)

ABSTRACT:As global warming became a cause of concern in the 1980s, researchers and climate activists initially paid little attention to the possible health effects of a warmer world. This changed quickly between 1985 and 1989, when scientists working on contracts with the US Department of Energy and the Environmental Protection Agency extrapolated from existing knowledge about the impact of weather on health to speculate about how global warming would impact health. However, they downplayed the impact of their (...) contributions by highlighting the uncertainty in their models and the adaptability of human societies. Since that time, physicians and other health scientists have maintained a steady drumbeat of warnings about the health effects of global warming. They have published widely in the medical literature and participated actively in international scientific collaborations. Their research has significantly increased the breadth and depth of climate-health science and shown that measurable impacts of global warming have already begun. But as the many climate crises of 2023 show, action against global warming remains inadequate. Is it still reasonable to hope that health advocacy will incite communities and politicians to act? The history of climate and health advocacy reveals many obstacles that must be overcome. (shrink)

In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence‐based, collaborative and recovery‐focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, (...) innovative and influential thinkers of the 20th century. However, rather than focusing exclusively upon the content of Foucault's work, it will be suggested that it is possible to discern a general methodological approach across that work, a methodological approach that he refers to as “the history of the present.” In doing so, Foucault's history of the present can be understood as a productive, albeit provisional, framework in which to orientate the purpose and process of critical thinking for mental health professionals by emphasizing the need to both historicize and politicize the theoretical perspectives and therapeutic practices that characterize contemporary mental health care. (shrink)

The article considers the history of electroshock therapy as a history of medical technology, professional cooperation and business competition. A variation of a history from below is intended; though not from the patients’ perspective (Porter, Theory Soc 14:175–198, 1985), but with a focus on electrodes, circuitry and patents. Such a ‘material history’ of electroshock therapy reveals that the technical make-up of electroshock devices and what they were used for was relative to the changing interests of physicians, (...) industrial companies and mental health politics; it makes an intriguing case for the Social Construction of Technology theory (Bijker et al., The social construction of technological systems: new directions in the sociology and history of technology. MIT Press, Cambridge, MA, 1987). (shrink)

The social and cultural history of medicine and health is a growing field of research in Sweden, stimulated by the present political, economic and social concern about health and health care. Since there have never been any chairs in the history of medicine within the medical faculty, the topic has mostly been approached by historians of science and ideas, social historians and anthropologists and sociologists interested in long-term developments. Psychiatry and psychiatric care is one of (...) the most popular subjects. Other fields are professional history and social policy, cultural and local studies on different aspects, epidemics and public health and socio-demographic studies of mortality and morbidity. This report presents some major Swedish contributions and gives a short summary of some of the results. There has, during the recent years, been a trend towards interdisciplinary exchange, for instance through Swedish and Scandinavian networks, and towards an international orientation that has led to comparative studies and exchange of results, a trend that can also be observed in many other countries. (shrink)

ABSTRACT At the beginning of the twentieth century, health research in the Sudan developed primarily as a function of the colonial British administration. Ethical issues in the medical profession in the Sudan are governed by the Sudan Medical Council. To address these issues, the Sudan Medical Council issued Medico‐legal and Ethical Guidelines in 1967. This important document has focused principally on ethical issues arising in clinical medicine. Throughout the history of health research in Sudan it is very (...) difficult to find any reference to research ethics. Nevertheless, there have been a few attempts to articulate ethics in health research. In 1979, Sudan witnessed the establishment of the first ethical review committee, which was established by the initiative of a group of doctors and scientists from the national health research laboratory. This committee got neither political nor institutional recognition. Therefore, it was not developed and came to an end shortly after its inception. Yet, in 2000 the FMOH established an ethical review committee (ERC). The functions of this committee were to review proposals of health research to be carried out in the country for ethical issues irrespective to the funding agents. Unfortunately, the committee devoted all the jobs in reviewing only externally‐sponsored health research and research carried out by expatriate researchers or international organisations. (shrink)

Between 1983 and 2006 there were two distinct sorts of historical writings on Southeast Asian medical history, with quite different emphases. Some historians focused on the history of medicine in national contexts—a practice that resulted in the neglect of larger socioeconomic factors such as migration—that affected the trajectory of pandemics. At the same time, pursuing a different line of thinking, another group of historians focused on the history of specific diseases from a demographic perspective. These two approaches (...) led to very different conclusions about the nature of epidemic disease and pandemics that have beset the region since the nineteenth century. Nevertheless, regional histories of health are neglected in Southeast Asian medical history in favor of either local, national, or global histories. In this essay, I argue that if historians of global health have forsaken the region in favor of the wider world, Southeast Asian historians have neglected the region in favor of the nation. What is missing in Southeast Asian medical history is a regional perspective that would help understand the ways in which pandemic responses are shaped by colonial, Cold War, or national concerns. Beginning 2019, some historians and political analysts trying to understand global pandemics have adopted a regional approach by treating, as a monolithic group, the ASEAN—the Association of Southeast Asian Nations, which is a regional grouping of Southeast Asian member states, established in 1967. By contrast, others explore specific geographic, political, or economic issues that have contributed to either the spread or containment of disease. In this regard, the COVID-19 crisis in Southeast Asia merits historical attention to comprehend the strengths and weaknesses of a regional approach. (shrink)

While aging research and policy aim to promote ‘health’ at all ages, there remains no convincing explanation of what this ‘health’ is. In this paper, I investigate whether we can find, implicit within the sciences of aging, a way to know what health is and how to measure it, i.e. a theory of health. To answer this, I start from scientific descriptions of aging and its modulators and then try to develop some generalizations about ‘health’ (...) implicit within this research. After discussing some of the core aspects of aging and the ways in which certain models describe spatial and temporal features specific to both aging and healthy phenotypes, I then extract, explicate, and evaluate one potential construct of health in these models. This suggests a theory of health based on the landscape of optimized phenotypic trajectories. I conclude by considering why it matters for more candidate theories to be proposed and evaluated by philosophers and scientists alike. (shrink)

The history of nursing in the home: revealing the significance of place in the expression of moral agency The relationship between place and moral agency in home care nursing is explored in this paper. The notion of place is argued to have relevance to moral agency beyond moral context. This argument is theoretically located in feminist ethics and human geography and is supported through an examination of historical documents (1900–33) that describe the experiences and insights of American home care/private (...) duty nurses or that are related to nursing ethics. Specifically, the role of place in inhibiting and enhancing care, justice, good relationships, and power in the practice of private duty nurses is explored. Several implications for current nursing ethics come out of this analysis. (i) The moral agency of nurses is highly nuanced. It is not only structured by nurses’ relationships to patients and health professionals, i.e. moral context, it is also structured by the place of nursing care. (ii) Place has the potential to limit and enhance the power of nurses. (iii) Some aspects of nursing's conception of the good, such as what constitutes a good nurse–patient relationship, are historically and geographically relative. (shrink)

The paper uses two historical examples, public health (1840-1880) and town planning (1945-1975) in Britain, to analyse the challenges faced by goal-driven research, an increasingly important trend in science policy, as exemplified by the prominence of calls for addressing Grand Challenges. Two key points are argued. (1) Given that the aim of research addressing social or global problems is to contribute to improving things, this research should include all the steps necessary to bring science and technology to fruition. This (...) need is captured by the idea of practical integration, which brings this type of research under the umbrella of collective practical reason rather than under the aegis of science. Achieving practical integration is difficult for many reasons: the complexity of social needs, the plurality of values at stake, the limitation of our knowledge, the elusive nature of the skills needed to deal with uncertainty, incomplete information and asymmetries of power. Nevertheless, drawing from the lessons of the case studies, it is argued that (2) practical integration needs a proper balance between values, institutions and knowledge: i.e. a combination of mutual support and mutual limitation. Pursuing such a balance provides a flexible strategy for approximating practical integration. (shrink)

There is much discourse and focus on the social determinants of health, but undergirding these multiple intersecting and interacting determinants are legal and political determinants that have operated at every level and impact the entire life continuum. The United States has long grappled with advancing health equity via public law and policy. Seventy years after the country was founded, lawmakers finally succeeded in passing the first comprehensive and inclusive law aimed at tackling the social determinants of health, (...) but that effort was short-lived. Today the United States is faced with another fork in the road relative to the advancement of health equity. This article draws on lessons from history and law to argue that researchers, providers, payers, lawmakers and the legal community have a moral, economic and national security imperative to address not only the negative outcomes of health disparities, but also the imbalance of inputs resulting from laws and policies which fail to employ an equity lens. (shrink)

The Medical Research Council National Survey of Health and Development (NSHD) is Britain’s longest-running birth cohort study. From their birth in 1946 until the present day, its research participants, or study members, have filled out questionnaires and completed cognitive or physical examinations every few years. Among other outcomes, the findings of these studies have framed how we understand health inequalities. Throughout the decades and multiple follow-up studies, each year the study members have received a birthday card from the (...) survey staff. Although the birthday cards were originally produced in 1962 as a method to record changes of address at a time when the adolescent study members were potentially leaving school and home, they have become more than that with time. The cards mark, and have helped create, an ongoing evolving relationship between the NSHD and the surveyed study members, eventually coming to represent a relationship between the study members themselves. This article uses the birthday cards alongside archival material from the NSHD and oral history interviews with survey staff to trace the history of the growing awareness of importance of emotion within British social science research communities over the course of the 20th and early 21st centuries. It documents changing attitudes to science’s dependence on research participants, their well-being, and the collaborative nature of scientific research. The article deploys an intertextual approach to reading these texts alongside an attention to emotional communities drawing on the work of Barbara Rosenwein. (shrink)

Amidst the climate of crisis surrounding the rise in opioid-related overdose in the USA, early in 2019, Google and Deloitte launched ‘Opioid360’. Here came a platform combining browser histories, credit, insurance, social media, and traditional survey data to sell the service of risk calculation in population health. Opioid360's approach to automating risk calculation not only promised to identify persons ‘at risk’ of opioid dependence, but also paved the way for broader applications anticipating common chronic diseases and coordinating logistical operations (...) involved in pandemic response. Beginning with this experimental platform, this paper develops an analysis of the Big Data mode of risk calculation - an epistemological and political shift that involves technology companies, investors, insurers, governments, and public health institutions. The analysis focuses on the re-emergence of ‘social determinants of health’ in the rhetoric accompanying novel analytic platforms that estimate, calculate, and compute individual health risks. While the treatment of SDOH has always been a site of political contestation within the discipline of public health, powerful interests are crystallising around the concept and instrumentalising it in platforms that sell algorithmic prediction. Silicon Valley's breed of asset-oriented technoscience appears not only to be amplifying the behaviouralist elements of public health. Among the stakes of the Big Data mode is the paradoxical retreat from changing social conditions that contribute to the prevalence of health and illness in populations; and instead, the promotion of an apparatus for pricing and exchanging individual risk or excluding from services those who bear risk most acutely. (shrink)

This essay revisits the scholarly production around three major pandemics in the region: (a) the Third Plague Pandemic; (b) HIV/AIDS in the 1980s; and (c) COVID-19. The essay aims to provide a comprehensive set of resources (both printed and digital) in four languages (Portuguese, Spanish, English, and French) to examine how scholars have approached these phenomena and how their scope and interpretations have changed over time. Historians of health paid particular attention to sociocultural aspects of the disease, which enabled (...) them to consider usually-neglected actors, such as patients of Indigenous and African descent with their own medical traditions. This added more complexity to our understanding of how these pandemics were fought and received. In addition, the essay suggests that COVID-19 prompted the emergence of historians of health as public scholars. They actively used social networks and other digital tools not only to communicate about the long history of diseases and pandemics in the region, but also to provide an authorized or informed perspective amid misinformation and fake news. In addition, the internet was crucial to the development of helpful databases and virtual conferences beyond academic campuses and paywalls. (shrink)

Italian medical history in the age of positivism showed a strong interest in epidemics. This can be seen in Alfonso Corradi’s monumental Annali (1865-1895) and in works of other 19th-century historians who addressed major public health issues in the newly unified country. Local history was also widely practiced in Italy, and it was instrumental in discovering and publishing a wealth of documentation on past epidemic and endemic diseases, as well as on measures such as quarantines that were (...) invented or introduced in the peninsula as early as the late Middle Ages. The way Italian historians looked at epidemics in the 20th century was shaped by politics, religion and literature more than by demography, epidemiology, or technical knowledge in the medical field. This article and its accompanying bibliography will focus on regional historiography and deal with the history of plague, smallpox, cholera and malaria, and other diseases addressed in works published after the 1980s. (shrink)

Two essential periods may be identified in the early stages of the history of vitamin D-resistant rickets. The first was the period during which a very well known deficiency disease, rickets, acquired a scientific status: this required the development of unifying principles to confer upon the newly developing science of pathology a doctrine without which it would have been condemned to remain a collection of unrelated facts with very little practical application. One first such unifying principle was provided by (...) the notion of hygiene; while the blanket explanations provided by this notion alone were much too general to enable rickets to achieve scientific status, it did point out the need to look for specific external causes for the disease and to examine the life-style and dietary habits of the patients. The second phase of the conceptualization of the disease was the assumption of a specific cause — that is, using concepts developed in the area of infectious diseases. This was made possible by fundamental similarities between deficiency and infectious diseases, in spite of their apparent differences. Both types of illness have some of the characteristics of what Georges Canguilhem calls the ontological representation of disease as opposed to dysharmonic representations, which primarily concern the endocrine diseases. It is precisely this shift from one to the other manner of perceiving ill health that enabled the identification of the vitamin D-resistant rickets. Conceptualization of the notion of vitamin D resistancy required that the conditions causing the disease be looked for within the organism rather than outside it; this was thus the first time that endocrine concepts were applied to studying the physiology of vitamin D.The history of resistant rickets therefore represents an interesting model for understanding the growth of biomedical knowledge. It allows the development of a number of more general ideas on the question of the relationship between biology and medicine and on the thorny problem of specificity in medical thinking. As far as this topic is concerned it can be seen that there was an ongoing exchange between medical and biological thinking during the initial period up until 1937, and that one could deny any such specificity in medical thinking during this same period. Albright, for example, used human diseases as spontaneously produced models for experimental biology. It was also more feasible for an experimental biologist to administer toxic doses than for a clinician to do so.What, then, if any, is the place of the specificity of medical thinking in this history? The fact that medicine is characterized not only by it ccognitive content78 but also by its final aim, which is to restore health, makes it necessary to take factors other than objective knowledge into consideration. This is particularly evident in two aspects of medicine, therapeutics and nosology, and in approaching the notion of pathological individuality.Therapeutic activity has a largely empirical approach. Many drugs, such as cod-liver oil, were discovered empirically. Treatment often in the past, and still now, has proceeded by trial and error, upon no established theoretical basis. At this level the relationship between biology and medicine is roughly comparable to that between science and technology79 \3- that is, it is impossible to reduce either therapeutics or technical activities to the simple application of basic science. In this sense, the application of vitamin D to vitamin-resistant rickets is quite typical. Further-more, in the case studied here, the therapeutic activity heralds a definite breaking away from the medicatrix naturae of conventional medicine dating back to ancient times, and it embodies a new concept of the organism and of disease: no longer can the diseased organism be thought of as merely having a perturbed equilibrium requiring restoration by means of a natural style of medicine. On the contrary, vitamin D resistance is an obstacle that indicates profound biological dysfunction, to be rectified only by means of an extremely aggressive and therefore dangerous therapy. The therapy thus serves to reveal the severity of the dysfunction, thereby leading inevitably to conceptual innovation. This sheds light on the theoretical innovations of which the therapeutic activity is capable.Therapeutic activity is also influenced by notions of health and illness, normal and pathological states, none of which may be determined entirely objectively. For example, the term healing as used by Albright in the case of resistant rickets that he described may be discussed in this light.Nosology, or the classification of diseases, depends largely on the description of clinical syndromes, which are themselves mainly based on subjective elements (discomfort, disability, or the extent of a patient's suffering). The advent of pathological anatomy at the beginning of the nineteenth century disrupted classification by introducing the concept of localized anatomical lesions81-and, hence, an element of material objectivity \3- into nosology. Radiological examination further complicated matters by enabling the equivalent of an autopsy on living matter. Lastly, biological examination complicated nosology by showing that biological anomalies may exist in human beings without necessarily leading to a pathological condition. Medical thinking can choose to combine all these elements to describe a disease, but can also separate them and retain only a few, or a single one, according to requirements - as did Albright.The notion of biological and pathological individuality is fundamental to the development of medical thinking. Whatever its theoretical origin, medical thinking has since ancient times incorporated the idea that each individual reacts differently to the same treatment and his own specific pathological tendencies. I mentioned earlier that in the history of vitamin D-resistant rickets the notion of rachitic tendency reflected this type of thinking. After 1937, this history progressed by successively separating new individual entities, affecting smaller and smaller groups of individuals in each case. In other words, the need to understand and to define individual illness more closely required the development of new concepts and the construction of new individual categories of disease linking these concepts to older clinical, radiological, and biochemical elements. (shrink)