The French human sciences and the crafting of modern subjectivity,
origin of human knowledge ( Essai sur l’origine des connoissances humaines (1749)), for example, Condillac provided an explanation of the mind that relied solely on the faculty of sense perception and the mind's basic capacity for ‘attention’. Within this framework, the mind was continually affected by three possible causes: impairment of the sense organs, different ways of processing sense perceptions, and types of storage and connection of these perceptions in the form of ideas.
His basic hope, and that of Destutt
increased incidence. 4 Strong policy networks had been established around the condition by the early 1990s, and lobbyists drew government attention to diabetes’ growing financial and human costs. Responding to these concerns, the GP contract included incentive payments for special diabetes management clinics. 5 Focused treatment within primary care would, the Department of Health hoped, provide a cost-effective way to reduce troubling rates of diabetes’ long-term ocular, renal, hepatic, neuropathic, and cardiovascular complications.
) expelled in the urine) remained a key aim of intervention. For patients deemed to be overweight, weight reduction accompanied the pursuit of control in the hope that metabolic dysfunction might be subsequently relieved. Practitioners thus sought to balance dietary schemes and – where required – insulin regimes as well as possible with a patient's metabolic capacities and work demands. 6 Laboratory surveillance and monitoring for signs of long-term complications also remained central to management programmes. Most hospital doctors encouraged patients to test their own
Projects like the SMD-funded retinopathy screening trials reflected the British state's growing engagement with diabetes during the 1980s. In that specific instance, the DHSS's hopes for generating organisational guidance for the NHS were disappointed. Central state interest in diabetes management, however, remained undimmed, and much more extensive standards for diabetes care would be produced by the new millennium.
The work of elite practitioners and specialists proved integral to maintaining state interest in both
, the Thatcher and Major governments were also motivated by a long-held desire of the British state to control NHS costs, and later initiatives built upon developments that took place before the 1980s.
Parliament and the Treasury had placed constant pressure on NHS budgets since 1948. Initial hopes that expenditure would decline as national health improved were dashed very quickly. Governments tried numerous strategies over the post-war period to control costs, ranging from the introduction of charges (most notably for prescriptions in the 1950s
Health as moral economy in the long nineteenth century
acts through which people could successfully invoke those conceptual frameworks. In the absence of objective tests of suffering – and there were more of these than we may realise – by what magic words does one establish one's claim? And how does this vary by speaker, place, and conditions? We might hope to discover too the determinants of the quality of response a claim elicited – minimal, grudging, and brief, or sympathetic, long-term support? For my goal here is to explore not only the kinetics of the medical moral economy but also its dynamics for progressive
revealed that such characteristics were preponderant amongst people who developed diabetes. 37 Moreover, transitioning from statistical prediction to causative concepts of risk, Pike viewed targeted case-finding as necessary because intervention before symptoms became ‘marked’ offered the best hope of preventing complications. 38
For more radical interlocutors, such work would form part of an expanded GP role in chronic disease surveillance more broadly. For instance, according to R. F. L. Logan of the innovative Darbishire House research team at
could prevent ‘wasteful duplication of effort’ and allow errors to be checked and corrected. 85 Indeed, the Poole clinical lead hoped that computerisation would provide a ‘method of assessing the follow-up and control of patients not regularly seen in the clinic’. 86 Although it was potentially a hospital plan to manage GPs, no punitive measures could be devised in a programme dependent upon co-operation. 87 The designers simply hoped that the record would increase visibility of errors for care teams, with practice review forming the basis for changed behaviour
‘bankruptcy of some of their youthful hopes’.
Indeed, in a series of mini case studies that prefigured Jaques's approach, Hall referred directly to ‘the middle-age crisis’ experienced by Nietzsche in his thirties.
Similarly, Jung's central concept of individuation (or integration of the self), with its emphasis on development across the second half of life, was assembled by juxtaposing case histories, notions of an archetypal life course and reflections on his own midlife
Dr Williams’ Pink Pills for Pale People and the hybrid pathways of Chinese
Medicine Co. vs. Alexander’, Cases Decided in the Supreme Court of the Cape of Good Hope During the Year 1905 , vol. 22 (Cape Town: J. C. Juta & Co., 1907), 589.
These foreign-language advertisements did employ testimonies from local residents, but no artwork. As I will later discuss, visual images formed a central component of Chinese-language advertisements for Dr Williams’ Pink Pills for Pale People