More Than Hot: A Short History of Fever (Johns Hopkins Biographies of Disease)
Format: PDF / Kindle (mobi) / ePub
Christopher Hamlin’s magisterial work engages a common experience―fever―in all its varieties and meanings. Reviewing the representations of that condition from ancient times to the present, More Than Hot is a history of the world through the lens of fever. The book deals with the expression of fever, with the efforts of medical scientists to classify it, and with fever’s changing social, cultural, and political significance.
Long before there were thermometers to measure it, people recognized fever as a dangerous, if transitory, state of being. It was the most familiar form of alienation from the normal self, a concern to communities and states as well as to patients, families, and healers.
The earliest medical writers struggled for a conceptual vocabulary to explain fever. During the Enlightenment, the idea of fever became a means to acknowledge the biological experiences that united humans. A century later, in the age of imperialism, it would become a key element of conquest, both an important way of differentiating places and races, and of imposing global expectations of health. Ultimately the concept would split: "fevers" were dangerous and often exotic epidemic diseases, while "fever" remained a curious physiological state, certainly distressing but usually benign. By the end of the twentieth century, that divergence divided the world between a global South profoundly affected by fevers―chiefly malaria―and a North where fever, now merely a symptom, was so medically trivial as to be transformed into a familiar motif of popular culture.
A senior historian of science and medicine, Hamlin shares stories from individuals―some eminent, many forgotten―who exemplify aspects of fever: reflections of the fevered, for whom fevers, and especially the vivid hallucinations of delirium, were sometimes transformative; of those who cared for them (nurses and, often, mothers); and of those who sought to explain deadly epidemic outbreaks. Significant also are the arguments of the reformers, for whom fever stood as a proxy for manifold forms of injustice.
Broad in scope and sweep, Hamlin’s study is a reflection of how the meanings of diseases continue to shift, affecting not only the identities we create but often also our ability to survive.
child, using “strength (not force) to hold her in bed.” She has learned, she explains, the need for “unremitting watchfulness,” for delirious patients can be cunning. Slowly, over the six weeks of the case, the author trains the mother to take on some of the watching so that she can have time for a brief rest or walk. The most poignant of the pamphlets is Nursing Typhoid (1910). Disembarking at a rural station, the author treks six miles further. “I was to be alone in the heart of the country
University Press, 1959), �§83–84. Working out looms large in Hippocratic medicine. See Vivian Nutton, Ancient Medicine (London: Routledge, 2004), 64. 2. Hippocrates, Regimen II, in Hippocrates: Volume IV, �46. 3. Galen, On the Causes of Diseases 2.2, in Galen on Diseases and Symptoms, translated, with introduction and notes, by Ian Johnston (Cambridge: Cambridge University Press, 2006), 161. 4. See John Huxham, An Essay on Fevers, introduction by Saul Jarcho, MD (Canton MA: Science History,
Including Physic, Surgery, Anatomy, Chymistry, and Botany, in all their branches relative to Medicine. Together with a History of Drugs; . . . ., 3 vols. (London: T. Osborne, 1744–45), vol. 3, s.v. “pyrexia”; James, Dissertation (1778), 81–85. 27. James, Dissertation (1778), 85–87, 70. 28. Ibid., 88, 2–3. James did not rely solely on the powder; he also bled, blistered, applied cataplasms, ordered clysters, used oral purges, and supplemented with bark or musk (24, 127–28). Cf. William Cullen,
medical sectarianism, and states’ unwillingness to regulate medical training or practice worked to defeat any common context. A few with access to large hospitals, such as Austin Flint in Buffalo, New York, might emulate Parisian research, but often appeals to Paris, and later to Germany, were about what American medicine should be, not what it was.44 Such was the context of Elisha Bartlett’s polemics. In 1827 the New Englander Bartlett (1804–1855) was in Paris, where he became a follower of
typhoid may be seen as a “peculiar enteritis” and that the lesions of the Peyer’s patches are inflammatory. But it is a special inflammation.48 Instead, Bartlett would appeal in another direction, suggesting that the proper analogue of the distinctive lesion is the unique rash in measles, scarlet fever, and smallpox. Surely, a rash on an inner surface—a “pox on the ileum”—was just as likely as a rash on an outer surface.49 In the exanthems, the characteristic rashes might not significantly