Muhammad Adil Malik

01065192
Essay 3

Compare and contrast at least two historical examples in which race,

gender, or social class played an important part of scientific or industrial
development.
The development of proto-modern medicine as a science centered immensely upon the symbolic and
romanticized significance of an individual's blood and its implications pertaining to one's family, gender
and race1. The so called Foucauldian "medical gaze"2 of a Doctor and disease identity were greatly
shaped by the discourse surrounding the patients background, often constructed to reinforce certain
gender/racial stereotypes and anxieties. Early medical pursuits not only utilized hematological studies to
this effect, rather in an increasingly technological world other race-centric and gender-centric metrics
such as the "vital lung capacity" were also constructed and misrepresented. This essay will explore how
the precursor to the modern and complex molecular-genetic view of disease identity has its roots in a
much more naïve and direct interpretation of an individual's blood parameters together with their social
and racial background. The essay begins by examining the case of the now defunct interpretation of
Chlorosis3 or so called "girl’s anemia" and how its existence actually highlighted an oppressive and old
fashioned perception of women of the time. The disease identity and professional role set of a doctor
forged out of this will be contrasted with the role of a bold and heavily masculine surgeon, emerging out
of post-industrial/war optimism4. The development of hematology will then be explored in the context
of a racially segregated America, to show how certain diagnostics tools such as Emmel’s blood test were
developed around the racial discourse of the time and were then leveraged to justify racial segregation.
In addition to the development of Hematology, the essay will compare this to the birth of the
Spirometer5, and how the application and interpretation of established health metrics such as "vital lung
capacity" shaped Pulmonology with the backdrop of gender, race and social class. Finally, the essay will
briefly explore how some modern medical instruments are still "race calibrated" and how the questions
of race and gender are negotiated in medicine today.

The development of the study of blood i.e. Hematology and in particular Chlorosis offers strong insight
into the social anxieties present pertaining to the role and position of women in society. In the early
1800's, the Industrial Revolution was redefining the age old views about women's role in society6, and
the shift towards a technology driven society and medical diagnostics influenced the emerging study of
blood and the role of a Hematologist. At the inception of this new industrial boom, worker rights were
scarce and working conditions were poor, affected women were often instead diagnosed with Chlorosis
or the so called "girl’s anemia". The disease’s identity was shaped not only by the perceived role of
women, reflecting the general discourse of disapproval towards this change, but also signified the
exploitation of women in this era. Once diagnosed, the general medical consensus classified the
condition as a moral deficiency where among other things women were said to be overworked with

1
Foucault, 1976
2
Foucault, 1963, p.191
3
Wailoo, 1997, p.32
4
Ibid, p.66
5
Braun, 2014, p.23
6
Ibid, 3, p.41

1
Muhammad Adil Malik
01065192
Essay 3

their roles misplaced in society. The determined cure was rest and a return to a more traditional familial
role. Not only do we see a new series of diseases being created out of this discourse but the role of
medicine and medical professionals is also shaped. A family doctor, the equivalent of a medical
professional of the time was now perceived as someone who reinforced existing social paradigms and
advocated strong moral management in order to preserve women's' role in society7. Similarly,
rehabilitation schemes and clinics evolved around the same theme, as physicians saw themselves as
moral supervisors who would regulate the life of women in care, to study the perceived disease.

While disease identity and professional role set pertaining to women developed around preserving
traditional family values the emerging persona of male physicians and surgeons was contrastingly
radical. Male surgeons, armed with the latest medical technologies were increasingly expected to push
the boundaries of acceptable medical intervention and any controversy was seen as part of the
"adventure". This medical development can be attributed to the wider gender dynamics at play, in
particular the chauvinistic sentiments of men in the era, spurred on by the newly found confidence in
the face of navigating adverse working conditions and wartime rhetoric. Medical publications of the
early 1900's saw Surgeon's accounts often glorify surgery alongside swift disease classification and
operation as a very masculine and prudent pursuit, in an era where the human body was still considered
deeply sacred for in vivo treatments8.

The emerging role of men as disease identity designators had major effects, surgeries such as Spleen
removal, no longer deemed significant by modern medicine, saw a sharp increase in operation rates in
the 1930’s and consequently deaths due to improper operations. This nonetheless served as a catalyst
to a major change in medical philosophy thereafter. A key characteristic of proto-modern medicine was
the belief that true manifestation and hence characterization of a disease required minimum
intervention from both the patient and the doctor9. However, this new interpretation, inspired by the
emerging definition of masculinity at the time, signifies an epistemic change where doctors had an
increasingly can-do attitude of "cut the body open and make the diagnosis"10

Medical development of Hematology and disease identity in post war American in the 1950’s developed
strongly around the discourse of race as opposed to gender in the case of Chlorosis in Britain. This was
because the dominating social anxiety surrounding American society at this time, was less so the role of
women rather it was segregation and the question of African-American mobility, interracial marriages
and race mingling. However, the key infatuation in this period continued to be Blood and the belief that
enclosed within it are the secrets of one's hereditary kin and clan. A cornerstone of segregation at the
time was the belief that interracial marriages would eventually spread "impure" blood and disease such
as sickle cell anemia into Whites. The sickle cell trait was found predominantly in Africans and is now
accepted to have been evolved to offer resistance against the Malarial parasite. However, in the 1950's
this lead to a very racialized interpretation and pursuit of the Mendelian thesis of genetics11.
Furthermore, the racial discourse and the assumptions about black-white relations even shaped the

7
Ibid, 3, p.18
8
Ibid, 3, p.66
9
Ibid, 2, p.8
10
Ibid, 3, p.53
11
Ibid, 3, p.150

2
Muhammad Adil Malik
01065192
Essay 3

development and interpretation of the diagnostic technology of the time such as Emmel's blood test
which was used to gauge the susceptibility of a patient's blood to sickle. As the discourse now was to
demonstrate the underling incompatibility of races and moreover the imminent yet latent threat of
interbreeding, disease identify changed completely from being symptom driven to susceptibility driven.
African-Americans whose blood sample was prone to sickle after Emmel's blood test12 were considered
diseased vectors, despite often being symptom free. This methodology contrasts sharply with the case
of women and Chlorosis where physically visible symptoms formed the identity of the disease as
opposed to some inert susceptibility. This was a clear reflection of the fear and mistrust towards the
African-Americans at the time. Interestingly, we see the role of physicians in society regress back to
what it was in Britain in the early 1800's at the inception of the "girl’s anemia" endemic. Physicians were
now once again seen as having roles of identity/moral managers or more specifically the "race police",
drawing the lines between the pure and impure and endorsing racial segregation.

An interesting comparison can also be made within the Foucauldian framework of "medical gaze"13. By
the early 1920's in Britain, the traditional interpretation of Chlorosis was seen as a relic of the Victorian
era and a more patient centric interpretation of disease identity emerged. The role of medicine was now
seen to be sympathetic study of the patient to administer symptom relief, as opposed to viewing the
patient simply as a vessel of medical knowledge for the sole purpose of accurate disease
characterization. Foucault had summarized a similar medical discourse in France as "What is the matter
with you?" and after the French Revolution to “Where does it hurt?"14. The emerging discourse in
segregated America of the 1940’s was still very much the latter of the two.

By just considering the previous examples in isolation, one might conclude that the developmental
susceptibility of medicine, specifically Hematology to racial and gender stereotypes was simply due to
the age old racial and gender connotations associated with Blood. However, comparing this to other
areas of medicine such as the Pulmonology and the use of the Spirometry, offers additional
explanations. Post war optimism increasingly saw the role of medicine and disease identity as an
exercise in building a precise instrument to abstract away the multitude of human variations and justify
gender and racial classifications. As medical gaze now looked to statistically classify, a new metric "lung
capacity" developed, and was propped up as a summary of culturally resonant qualities such as fitness.
Naturally, a standard denoting "normal" and examples of outliers denoting the "diseased" had to be
established, these inadvertently incorporated any current understanding of race and gender. Firstly, the
standard of a healthy lung capacity was seen to be an upper class white man15. Next proto-modern
medical journals in the 1900's slowly morphed the term "lung capacity" into a much broader and
consequential "vital capacity"16. This was often used to squash out questions about class hierarchy: an
industrial worker would almost always register a smaller lung capacity than an elite after harsh
conditioning from the dubious working conditions of the time such as the famous cases of poisoning
from the industrial solvent Benzol. Similarly, insurance companies would justify discrimination of African
Americans based on the medical fact that on average, spirometer readings for healthy black adult males

12
Ibid, 3, p.156
13
Ibid, 2, p.149
14
Ibid, 2, p.19
15
Ibid, 5, p.2
16
Ibid, 5, p.3

3
Muhammad Adil Malik
01065192
Essay 3

would tend to be lower than that of white males17. Women's changing role was also opposed based on
their readings being lower to men. The interpretation of Spirometer readings was calibrated for race and
gender. It is interesting to note that despite the difference between the development of Hematology
and Pulmonology the key commonality between then was the insistence on constructing and
interpreting these singular body metrics as a justification for the prevalent social discourse.

Whether it be the interpretation of Blood or that of other bodily parameters such as vital lung capacity
the development of medicine was strongly influenced by the interplay of racial/gender discourse and
technology of the time. A central theme in all the cases is that increasing optimism towards technology
lead to very overarching interpretation of emerging medical diagnostics, not representative of the
perceived disease. In many cases the emerging disease identity was more indicative of the social
narratives of the time and doctors saw themselves as being defenders of social norms. In the case of the
"girl’s anemia" (Chlorosis), sufficient advancement in medicine by the 1920's eventually discredited the
diagnosis and recognized its routes not in gender health disparity rather gender exploitation18. The
interpretation of sickle cell anemia and lung capacity differences between races, were reinterpreted
when medicine collectively endorsed a more genetic and molecular explanation of these in the 1950's.
However, we can make the case that due to modern ventures that document genetic differences at an
unprecedented scale, such as the Human Genome Project, medicine is more prone that ever to develop
around and to be leveraged for racial or gender discrimination. It is important to realize that the essence
of modern medicine is still very much linked to the process of characterizing and documenting
differences between individuals, and simplifying the interpretation of medical reports by leveraging
understanding of the patient’s social background. For example, modern Spirometers are still "race
calibrated"19 and although this aids interpreting test results, it can lead to troublesome situations such
as demanding different standards for different races in the same medical compensation lawsuit20. One
must acknowledge that differences in genetic traits between races and genders are a useful medical
fact, however utilizing these to sanction differences without exploring the underlying causes and
meanings can be extremely problematic.

Word Count: 1982

Bibliography:
Braun, L., 2014. Breathing Race into the Machine, Minnesota: University of Minnesota Press.

Foucault, M., 1975. Birth of the clinic: an archaeology of medical perception / Michel Foucault ;
translated from the French by A.M. Sheridan Smith

Foucault, M., 1981. The history of sexuality

17
Ibid, 5, p.42
18
Ibid, 3, p.17
19
https://news.brown.edu/articles/2013/06/spirometers
20
https://webcache.googleusercontent.com/search?q=cache:5QAt6ZcNoaAJ:https://www.baltimoresun.com/news
/bs-xpm-1999-03-25-9903250041-story.html+&cd=1&hl=en&ct=clnk&gl=uk

4
Muhammad Adil Malik
01065192
Essay 3

Orenstein, D., Spirometry: A built-in 'correction' for race? | News from Brown. Available at:
https://news.brown.edu/articles/2013/06/spirometers [Accessed April 10, 2019].

Taylor, C., 2011. Foucault and Familial Power. Hypatia, 27(1), pp.201–218.

Texeira, E., 1990. Racial basis for asbestos lawsuits?; Owens Corning seeks more stringent standards for
blacks. baltimoresun.com. Available at: https://www.baltimoresun.com/news/bs-xpm-1999-03-25-
9903250041-story.html &cd=1&hl=en&ct=clnk&gl=uk [Accessed April 10, 2019].

Wailoo, K., 1995. Drawing blood: medical conceptions of disease in 20th century America, from chlorosis
to sickle cell anemia, Ann Arbor, MI: UMI.