YHR: Spring 2021

EDITORIAL BOARD
Esther Reichek, BR '23
Managing Editor
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THE YALE
HISTORICAL REVIEW
AN UNDERGRADUATE PUBLICATION
The Yale Historical Review provides undergraduates an
opportunity to have their exceptional work highlighted
and encourages the diffusion of original historical ideas
on college campuses by providing a forum for outstan-
ding undergraduate papers covering any historical topic.
Spring 2021
Volume XI
Issue I
Grace Blaxill, PC '23
Jisoo Choi, DC '22
Editors in Chief
Daniel Ma, BF '23
Louie Lu, BR '23
Executive Editors
Lane Fischer, MC '23
Production & Design Director
Aaron Jenkins, SY '22
Emma Sargent, TC '22
Gage Denmon, TD '22
Gabby Sevillano, TD '22
Katie Painter, TD '23
Lee Johns, BF '25
Natalie Simpson, GH '23
Assistant Editors
Alex Battle Abdelal, TC '25
Alex Nelson, SM '25
Deirdre Flanagan, BR '23
Eming Shyu, SM '25
Emma Yanai, DC '25
Katie Painter, TD '23
Logan Ledman, TC '24
Lucy Gilchrist, MC '24
Oliver Huston, TC '25
Copy Editors
Alex Nelson, SM '25
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Linh Pham, JE '24
Sharmaine Koh-Mingli, SM '22
Production & Design Editors
Cover by Alex Nelson, SM '25
i
THE YALE HISTORICAL REVIEW
Maya Ingram, MC '23
Social Media Chair
Marcus McKee, TC '23
Director of Humanities Now

LETTER from
the EDITORS
VOLUME XI ISSUE I SPRING 2021
ii
Welcome to the Spring 2021 Issue of the Yale Historical Review. With this issue, we return to
campus and to print publication, having bid farewell to previous editors and welcomed many
new ones to our ranks.
As managing editors,we inherited an organization with many strengths,but by far our greatest
asset was our robust, dedicated, and talented team of editors. After one of the strangest years
in its decade of existence, this issue marks our third term of editing an issue remotely. With
more editors and readers than ever before, we moved our editorial process online, Zooming
with authors and each other over the long months of the spring and summer to bring these
papers to you.
The product of those long pandemic months is an issue that features five extraordinary works
of undergraduate research, each with a strong reliance on and innovative use of primary
source media among other strengths. Liam Sheahan analyzes a collection of letters written
by one American soldier in World War II to explicate how the large scale events of the
war were affecting his individual psychology. Helen Zhang weaves together testimonies of
Korean and Chinese “comfort women” during and after the Japanese occupation, giving a
voice to traumatic experiences and delicately challenging the politics of memory and trans-
lation in the process. Alyssa Durnil investigates Irish support for Palestinian self-deter-
mination, tracing a movement that began with radical political factions but left a lasting
impact on the government of Ireland. Libby Hoffenberg zooms in on the early life of X-ray
technology and examines its rise during a medical and industrial turning point in American
history. Sophie Combs delves into the history of the Franco-American Orphanage in Lowell,
Massachusetts, demonstrating how a state institution became a battleground for modern
ideas of immigration, welfare, and community activism.
We plan to build on the foundations we’ve laid in an unprecedented year of publishing.
Expect an increase in original online content, continued conversations with the Yale commu-
nity, and more ways to engage with us both online and in person.
We’re proud to present to you five examples of excellence in undergraduate historical
research. We’re even more excited for you to see more excellence from us in 2022.
Sincerely,
Grace Blaxill, Editor in Chief
Jisoo Choi, Editor in Chief

CONTENTS
Technology and Paradigm:
The X-Ray, Electrical
Therapeutics, and the
Consolidation of Biomedicine
by LIBBY HOFFENBERG
How Comfort Women Speak:
The Politics and Social Norms
in the Narrations of Comfort
Women’s Experiences
by HELEN ZHANG
''Tiocfaidh Ár Lá, Our Day
Will Come'': Tracing the
Origins of Ireland's Support
for Palestine
by ALYSSA DURNIL
Pushing The Envelope: How
Personal Correspondence Can
Shape Our Understanding
of National Events
by LIAM SHEAHAN
iii
THE YALE HISTORICAL REVIEW
The Franco-American
Orphanage: Immigrant
Community and the
Development of the Modern
Welfare State, 1908–1932
by SOPHIE COMBS
PAGE 1
PAGE 15
PAGE 32
PAGE 70
PAGE 91

SPRING 2021
THE FRANCO-AMERICAN
ORPHANAGE
Immigrant Community and the Development of the
Modern Welfare State,1908–1932
by Sophie Combs, University of Massachusetts Lowell '20
Classroom of “orphans” circa 1920. [1]
Written for a Directed Study
Advised by Professor Robert Forrant
Edited by Esther Reichek and Aaron Jenkins
1

N 1908, OWNERSHIP of the Frederick
Ayer Mansion in Lowell, Massachusetts
passed from a millionaire investor to a com-
munity of immigrant workers. This change
corresponded to the industrial city at a moment of social
reckoning.At the time that organizers from St.Joseph’s pa-
rish fundraised to buy the property from the Ayer’s estate,li-
ving conditions and wages had degraded to abject lows.This
sprawling fortress—four stories tall, complete with stained
glass,pillars,and67rooms—wasatestamenttothefortunes
amassed in local mills and,subsequently,became a home for
the children of mill workers.In place of an elaborate house,
the French-Canadian church established an orphanage for
the care and education of children with working families.
The Franco-American Orphanage (FAO), first a manor
and then a childcare facility, can be considered emblematic
of the dual versions of Lowell created by industry in the
19th and early 20th centuries.1
Lowell’s orphanage was the result of local acti-
vism and can be understood as a formalized structure of
mutual aid. Financially, the FAO was symbiotic with its
community, both catering to and supported by the im-
migrant population of the city’s Little Canada.Founders
intended that the institution to provide short- and long-
term childcare services for families; in remembrance of
this objective,board members articulated,“In those days,
orphans did not receive any special consideration by the
civil authorities and the burden of education and caring
for those unfortunate children fell on the shoulders of
relatives.”2
By situating the FAO within the legacy of
American mutual aid, this paper asserts an alternative
interpretation of the orphanage in which the institution
1 This paper relies upon archival documents translated by the author from the original French. Additionally,
the character of the orphanage was assessed through several interviews of a former resident by the author. "Cul-
tural Resource Inventory – History of Ayer Home incl. Photos," Box 1 Franco-American Orphanage/School collec-
tion, Center for Lowell History.
2 Most influential in plans for the FAO was Reverend Joseph Campeau, who considered the orphanage his
"dream." For most of the FAO’s early life, board members were active members in St. Joseph’s Parish and/or local busi-
nessmen while the daily activities of the orphanage were run by women. "Fr. Campeau brings Grey Nuns to Orphan-
age," Box 1 Franco-American Orphanage School collection, Center for Lowell History.
3 Peter Kropotkin, Mutual Aid: A Factor of Evolution (London: Heinemann, 1902. Reprint, Mineola, New York:
Dover Publications, 2012), 7-8.
4 Donations varied in size and originated entirely from the Greater Lowell area. "Album Historique: Paroisse St.
Joseph Lowell, Mass. 1916," Box 1 Franco-American Orphanage/School collection, Center for Lowell History.
was the product of grassroots collaboration rather than
philanthropy in the patronizing sense.This reconceptua-
lization of the institution deviates from an individualistic
narrative of progress to one where the contributions of
working families are central.As expressed by the original
theorist of mutual aid, Peter Kropotkin, in 1914:
The leaders of contemporary thought are still inclined to
maintain that the masses had little concern in the evolu-
tion of the sociable institutions of man, and that all the
progress made in this direction was due to the intellectual,
political, and military leaders of the inert masses. […]The
creative, constructive genius of the mass of the people is
required whenever a nation has to live through a difficult
moment in its history.3
Ordinary people were responsible for the exis-
tence of the FAO.Notably,a donation campaign in 1914
to pay the $30,000 mortgage exceeded its goal by nearly
$10,000 and owed its success in large part to the contri-
butions of other immigrant groups.4
In following years,
the orphanage accepted increasing numbers of children
with Irish, Italian, and Syrian backgrounds. The FAO
was at once an institution rooted in its immigrant com-
munity, dedicated to the preservation of French-Cana-
dian heritage, and instilled with an ethos of multicultu-
ralism. As such, the orphanage can serve as a crucial case
study in grassroots organization.
In a broader context, social relief that was built
up from the grassroots had a long-standing effect on the
landscape of American welfare.In line with scholarship
by Matthew Crenson and Peter Fritzsche (1998), this
paper bolsters their claim that “welfare echoed charity
and its child-centered character recalled the institutio-
nal purpose of the orphanage itself,” positing that or-
phanages were the foundation, functionally and ideo-
INTRODUCTION
I
2
THE FRANCO-AMERICAN ORPHANAGE

logically, for subsequent developments in public relief.5
Jessie Ramey (2012), in the same vein, emphasizes the
agency of working-class people in establishing insti-
tutions thereafter absorbed into governmental struc-
tures. “Families were active participants in the history
of institutional childcare, making decisions and choices
that affected the development of early social welfare,”
Ramey notes.6
It is this process, wherein governmen-
tal structures are based in the charities that precede
them, which creates the decentralized, variable systems
of welfare coined by Alan Wolfe (1977) as a “franchise
state.”7
Michael Katz (1986) adds that “the boundaries
between public and private have always been protean
in America.The definition of public as applied to social
policy and institutions has never been fixed and unam-
biguous.”8
The FAO exemplified this ambiguity; it was
at once a private organization and one that received
funding from the Massachusetts government for acting
on its behalf. Institutions such as the FAO were the
product of mutual aid and later, to varying degrees, ab-
sorbed into the state. Mutual aid and American welfare
5 Matthew Crenson and Peter Fritzsche, Building the Invisible Orphanage: A Prehistory of the American Welfare
System (Cambridge: Harvard University Press, 2009), 325.
6 Jessie Ramey, Child Care in Black and White: Working Parents and the History of Orphanages (Chicago: Univer-
sity of Illinois Press, 2012), 1.
7 Alan Wolfe, The Limits of Legitimacy: Political Contradictions of Contemporary Capitalism (New York: Free Press,
1977). For further reading on decentralized welfare vis-à-vis orphaned children, see: S.J. Kleinberg, Widows and Orphans
First: The Family Economy and Social Welfare Policy, 1880-1939 (Urbana and Chicago: University of Illinois Press, 2006).
8 Michael B. Katz, In the Shadow of the Poorhouse: The Social History of Welfare in America (New York: Basic
Books, 1986), 2.
have in this way a historically porous relationship.
While immigrants created the model for com-
munity assistance in Lowell, top-down governmental
reform aimed to discriminate against immigrants dee-
med unassimilable into white society.In Massachusetts,
policymakers espousing eugenic and nativist beliefs
were instrumental in dismantling generalized institu-
tions of relief and replacing them with specialized insti-
tutions of rehabilitation. Reorganization of the welfare
state relied upon an ideological dichotomy between
“deserving” and “undeserving” paupers, with the lat-
ter subject to new apparatuses of policing. This paper
highlights the interrelation of ideology and structu-
ral implementation as articulated by John Mohr and
Vincent Duquenne (1997), who state:
Most historical accounts of social-welfare institutions
suggest that (1) the institutional logic of relief is com-
posed of two elements—a system of differentiated re-
lief practices (outdoor relief, the poorhouse, etc.) and
a system of symbolic distinctions consisting of various
The Ayer Mansion turned orphanage at an unknown date. The original 1859 house, the extension built in
1913, and the grotto for religious ceremonies are visible. [2]
3

normatively defined categories of the poor, and that
(2) these two systems are mutually constitutive in the
sense that changes in one corresponds to and constitutes
changes in the other.9
Contradiction,therefore,was built into the Mas-
sachusetts welfare state of the 20th-century. From the
top down, legislators and social workers organized sys-
tems of relief in accordance with racist objectives and,
from the bottom up,immigrant workers established mu-
tual aid societies that were later integrated into the state.
Immigrant communities were responsible for many of
the earliest forms of assistance; simultaneously,the emer-
ging welfare state was shaped by policy work steeped in
contempt for immigrants themselves.
In Lowell,the FAO existed as a community-fun-
ded childcare service. Despite the mainstream concep-
tion of the orphanage, the FAO was an institution that
provided temporary care for children with living families.
This paper’s analysis of administrative documents and
over 3,000 orphan records determines that (a) approxi-
mately 97% of children at the FAO had family members
paying dues and (b) 55% of orphans stayed at the institu-
tion for less than one year.“Orphans”were not forgotten
nor parentless children. Immigrants, already the engines
of economic growth for Lowell’s industries, were at the
forefront of bold initiatives to survive within harsh in-
dustrial conditions.10
These are the strands worth following from the
single orphanage in Lowell.The first section of this paper
investigates the political context of the FAO from local
and national perspectives,delving into currents of eugenic
thought that interwove 20th-century social work.An exa-
mination of Massachusetts legislative documents, notes
from state committee meetings, and contemporary litera-
ture points to a conception of poverty that was the basis
for enduring governmental reform.The second section de-
tails the situation of immigrants in Lowell, including the
health crisis brought on by industrial poverty, the history
9 John W. Mohr and Vincent Duquenne, "The Duality of Culture and Practice: Poverty Relief in New York City,
1888-1917" in Theory and Society 26, no. 2/3 (New York: Springer, 1997), 313.
10 Statistics calculated by author from financial records and over 3,000 admission records dated 1908 to 1932.
The 97% of orphans with paying family members was calculated from figures dated the year 1920. Despite inconsis-
tent records of orphans paying and not paying dues, the 1920 statistic appears representative of the FAO between
1908 and 1932. "Compter de l’Année," Box 3 Franco-American Orphanage/School collection, Center for Lowell History;
"Recorded Meetings of the Members of the Executive Committee of the Orphanage," Box 3 Franco-American Orphan-
age/School collection, Center for Lowell History; "Admission Records," Box 4 Franco-American Orphanage/School
collection, Center for Lowell History.
11 United States Children's Bureau, Child Care and Child Welfare; Outlines for Study (Washington: Federal Board
of French-Canadian presence in mill work, and the social
networks that sustained the community during economic
upheaval.Third, a statistical analysis of over 3,000 orphan
records at the FAO between 1908 and 1932 reveals the
function of the orphanage in the lives of Lowell’s working
people. Orphan ethnicities, parental occupations, city ori-
gins, and length of stay shed light on New England's mill
city at a moment of significant change.
T THE TIME of the FAO’s foun-
ding, Massachusetts was in the process of
constructing its welfare system. Within the
span of 60 years, Massachusetts establi-
shed a State Reformatory for Juveniles (1847), several
schools for “feeble-minded” children (1848), the State
Board of Inspectors (1851), the State Board of Charities
(1863), a Massachusetts Infant Asylum (1867), a State
Primary School for Dependent and Neglected Children
(1866), the State Board of Health (1879), an Industrial
School for Girls and for Boys (1908), and along with
many others. Specific categories of people—such as “ju-
veniles” or “feeble-minded youth”—were relegated into
institutions for rehabilitation.11
Simultaneously, facilities
that catered to broad swaths of the population,including
almshouses, were in the process of dismantlement. A fe-
deral report in 1921 understood this process as:
LICENTIOUS
MOTHERS
AND MENACING
CHILDREN
Political Context of
the Orphanage
A
4

Increasing differentiation and classification of those re-
quiring care, together with the tendency toward centra-
lization under State control of provision for these classes,
and the use of the family home instead of the institution as
a means of providing for dependent,neglected,and certain
classes of delinquent children.12
Classification of welfare recipients for the pur-
pose of separating, specializing in,or denying care was
foundational to Massachusetts reforms throughout
the 19th and 20th centuries. Paupers were divided
into official categories:
The poor are of two classes:first,the impotent poor,in which
dominion are included all who are wholly incapable of
work, through old age, infancy, sickness, or corporeal debi-
lity. Second, the able poor, in which denomination are in-
cluded all who are capable of work, of some nature or other,
but differing in the degrees of their capacity and the kind of
work of which they are capable.13
It was the understanding of this 1821 report that
the“evils”of poverty originated from the“difficulty of dis-
criminating between the able poor and of apportioning
the degree of public provision to the degree of actual im-
potency.”14
In the same vein,an 1866 annual report from
the Massachusetts State Board of Charities asserted that
“it is better to separate and diffuse the dependent classes
than to congregate them,” while providing instructions
for a “system of observation” in which to “collect all the
valuable facts” necessary for classification.15
In Lowell,
politicians regularly made distinctions between the
“worthy poor” and their unworthy counterparts, fretting
for the “idlers” who took advantage of state provisions.
Mayor James B. Casey expressed, “the giving of aid […]
for Vocational Education, 1921).
12 United States Children's Bureau, Child Care and Child Welfare; Outlines for Study, 1921.
13 Massachusetts Legislative Committee, The Josiah Quincy Report of 1821 on the Pauper Laws of Massachu-
setts, Written for the Massachusetts Legislative Committee (Boston: Massachusetts Legislative Committee, 1821).
14 Massachusetts Legislative Committee, The Josiah Quincy Report of 1821 on the Pauper Laws of Massachu-
setts, Written for the Massachusetts Legislative Committee, 1821.
15 Massachusetts Board of State Charities, Second Annual Report, January 1866 (Boston: Massachusetts Board
of State Charities, 1866).
16 Hon. John F. Meehan, Inaugural Address to the Lowell City Council (Lowell: Buckland Publishing Company).
17 DavidWagner, Ordinary People: In and Out of Poverty in the Gilded Age (NewYork: Paradigm Publishers, 2008), 17, 28.
18 Massachusetts State Board of Lunacy and Charity, Twenty-Eighth Annual Report (Boston: Wright and Potter
Printing Co. State Printers, 1906).
19 William H. Slingerland, Child Welfare Work in California: A Study of Agencies and Institutions (New York: Spe-
cial Agent Department of Child-Helping, Russell Sage Foundation, 1916), 195.
20 Robert A. Davis, Mentality of Orphans (Boston: Gorham Press, 1930), 164, 198.
as an injury is not only worked upon the family, but to
the community as well.” The objective of the state board,
Casey emphasized, was to ensure that charity only went
to paupers with no potential of self-sufficiency. Methods
of differentiating care were contingent on the idea that
some paupers were intrinscally unworthy.16
This conception of poverty was the ideological
foundation of the orphanage. A resolution from the
Massachusetts Board of Charities in 1864 warned of
“the unfavorable influences of [adult paupers], which, if
a child be long subjected to them, will always haunt his
memory,” and surmised that reform was only possible
for children. By 1895, Massachusetts had become the
first state to switch to a foster-care system that placed
children into rural families; such a move was justified
by fears for the “contaminating influences”of “licentious
mothers.”17
Reiterated in 1906, the Massachusetts State
Board of Charity and Lunacy pushed for “the separation
of the children at [the] institution from the more or less
contaminating influences of the adult inmates, most of
whom are from the lowest strata of life.” Adults coded
as “immoral” were disproportionately those from immi-
grant and working-class backgrounds.18
Anti-immigrant sentiment was not incidental to
welfare reform, but deeply integral to its design. In expli-
cit language, academic studies linked the “importation of
foreign laborers”to “dependency among adults and child-
ren,”and asserted as fact that “low class laborers,generally
of foreign birth or descent” have “menac[ing]” children.19
A professor from the University of Colorado warned of
both the“army of immigrants”and“army of human energy
among the ranks of the orphan population.” A “clear line
of demarcation,”he suggested,was the only solution to this
problem.20
The psychologist G. Stanley Hall remarked in
1916 that “from the standpoint of eugenic evolution alone
5

considered, [certain immigrant groups] are mostly fit for
extermination in the interests of the progress of the race,”
and was quoted in a study by the Russell Sage Foundation
on orphan children.21
Echoed in governmental reports,of-
ficials expressed that immorality was “inherited,” and as-
sessed that “vice and crime” were “forced upon [orphans]
by those whose blood courses in their veins.” Definitions
of worthy and unworthy paupers, upon which hinged the
creation of entire governmental entities, were steeped in
white supremacist convictions.22
To this point, a committee formed in 1851 entitled
the Massachusetts Board of Commissioners in Relation to
Alien Passengers and State Paupers conflated the threat of
homeless paupers with immigrant residents.The intention
of this organization was to “ascertain the names of all forei-
21 Slingerland, Child Welfare Work in California, 38.
22 Massachusetts Senate, Report of Committee on Public Charitable Institutions on Visits to Several Public Chari-
table Institutions Receiving Patronage of the State, no. 79, (Boston: Massachusetts Senate, 1851).
23 Massachusetts General Court, An Act to Appoint a Board of Commissioners in Relation to Alien Passengers and
State Paupers, May 24, 1851, chap. 347, (Boston: Massachusetts General Court, 1851).
24 Massachusetts General Court, An Act in Relation to Paupers Having No Settlement in This Commonwealth,
May 20, 1852, chap. 275, (Boston: Massachusetts General Court, 1852).
25 New York Board of State Charities, Twenty-first Annual Report of the New York State Board of Charities: Special
Report of the Standing Committee on the Insane in the Matter of the Investigation of the New York City Asylum for the
Insane (New York: New York Board of State Charities, 1887); Massachusetts Commissioner of Mental Diseases, Annu-
al Report of the Massachusetts Commissioner of Mental Diseases for the Year Ending November 20, 1924: Report of
Director of Social Service (Boston: Massachusetts Commissioner of Mental Diseases, 1924).
gners [...] and also procure all such further information in
relation to age,etc.[...] in order to identify them in case they
should hereafter become a public charge.”23
Following suit,
1852 witnessed the criminalization of vagrant paupers and
systemic deportations of the homeless; no less than 7,005
paupers were deported from Massachusetts between 1870
and 1878.24
Adjacent to welfare,the expansion of a diagnos-
tic apparatus saw to the practice of psychiatric evaluations
andthecollectionofpersonaldatainasylumsandprisons—
not dissimilar from processes for pauper classification and
the record-keeping of vagrants.The carceral state was for-
med in tandem with welfare.25
Amid these national trends, Lowell in the early
20th century operated as a self-contained welfare ap-
paratus. In the years leading up to the federalization of
Beds for children in the interior of orphanage, unknown date. [3]
6

welfare in the New Deal, Lowell assumed responsibility
for impoverished children and adults within its boun-
daries. In 1901, for example, the city invested a total of
$46,791.45 in relief, including expenses for ambulances,
food, medicine, surgeons, and coffins.26
The following
year, Lowell allocated $4,605.21 for the support of 98
orphans. Expenditures for dependent children ranged
between $1.25 (per orphan, per week) at St. Peter’s Or-
phan Asylum and $7.00 (per orphan, per week) at the
Children’s Hospital in Boston. Interestingly, Lowell’s
charitable budget made accommodations “on account of
Lowell’s paupers residing [elsewhere],” with payments
totaling $68.28 to Beverly, $482.25 to Lawrence, and
$542.28 to Boston in the year 1902.27
This system of lo-
calized responsibility can be understood as incentivizing
the tracking and policing of paupers, particularly with
programs geared toward behavior modification. In this
way, the framework for Massachusetts’ state welfare sys-
tem predated the “big bang” of Roosevelt’s New Deal
and was initially a localized process.
Contradiction was built into the DNA of Mas-
sachusetts welfare from the beginning.The fundamental
tenets of welfare—in which poverty was both a chari-
table cause and a moral failing to be discouraged—were
locked in existential conflict. As Michael Katz (1984)
has explained in his research on almshouses:
Built into the foundation of the almshouse were irre-
concilable contradictions.The almshouse was to be at once
a refuge for the helpless and a deterrent to the able-bo-
died. It was to care for the poor humanely and to dis-
courage them from applying for relief. In the end, one of
these poles would have to prevail.28
Development of the welfare state was shaped
by conflicting and discriminatory conceptions of care.
Demographic anxiety underpinned moves toward cen-
tralization and classification. Specialized institutions of
rehabilitation replaced generalized institutions of relief
26 Lowell City Council, Auditor's Sixty-Sixth Annual Report of the Receipts and Expenditures of the City of Lowell,
Massachusetts. Together with the Treasurer’s Account and the Account of the Commissioners of Sinking Funds for the
Financial Year Ending December 31, 1901 (Lowell: Buckland Publishing Company, 1901).
27 In turn, Lowell received funding from neighboring municipalities for their claimed paupers. Lowell City
Council, Report of the Secretary of the Overseers of the Poor for Lowell, January 1, 1902 (Lowell: Buckland Publishing
Company, 1902), 24.
28 Michael B. Katz, "Poorhouses and the Origins of the Public Old Age Home," in The Milbank Memorial Fund
Quarterly. Health and Society (Hoboken: Wiley, 1984), 118.
29 David Vermette, A Distinct Alien Race: The Untold Story of Franco-Americans, Industrialization, Immigration,
and Religious Strife (Montreal: Baraka Books, 2018), 98-111.
in order to omit care to low-income, non-native popula-
tions.As a result,immigrants in Lowell relied upon their
own community networks to build systems of assistance.
HE INTERRELATION OF industry and
immigration remains key to understanding
the economic context for French-Cana-
dians in Lowell. As early as the 1840s, mill
recruiters scoured depressed areas of Quebec for inex-
pensive labor, attracting wage-earners with the promise
of opportunity and personal betterment.A ten-day strike
following the reopening of Lowell mills after the Ci-
vil War further accelerated recruitment in Canada. By
1900, 24% of all cotton mill workers nationwide were
French-Canadian New Englanders;workers with at least
one French-Canadian parent comprised 44% of textile
operatives at this time.29
The dimensions of French-Ca-
nadian identity in the U.S. were, from the beginning,
economic in addition to cultural.In a presentation to the
Massachusetts Bureau of Labor Statistics, the editor of
the newspaper Le Travailleur elucidated this connection:
The Canadians are peaceful, law-abiding citizens; and
they accept the wages fixed by the liberality, or sometimes
the cupidity and avarice, of the manufacturers. […] Ca-
nadians have been great factors in the prosperity of ma-
nufacturing interests. Steady workers and skilful [sic],
the manufacturers have benefited by their condition of
THE FINEST
MILLS AND THE
DIRTIEST STREETS
Economic Context of
the Orphanage
T
7

poverty to reduce wages and compete favorably with the
industries of the Old World.30
Upon arrival to Lowell,French Canadians faced
deteriorating working conditions, living conditions,
and nativist backlash. Public officials who referred to
French-Canadians struck a careful balance between
demonization and appreciation of their contributions.
Simultaneously, immigrants were a “horde of indus-
trial invaders” and “indefatigable workers” supporting
the city’s most lucrative industries. Condemnation and
exploitation were not opposing forces but two sides of
the same coin. David Vermette (2018) demonstrates
that the degradation of industrial conditions coincided
with the shift from Yankee women to immigrants as
the principal source of labor in Lowell.The defamation
of French Canadians, such that they were referred to as
“sordid” and “an inferior race,” was both symptomatic
of and justification for the inhumane environment in
which they lived.31
Vermette explains,
It was the othering of the distinct, alien races in the mills
that made possible this dehumanization, the identifi-
cation of human beings with interchangeable machine
parts. Care and empathy extended to those within the
tribe and French-speaking Catholics of Quebec were not
members of the Yankee tribe.32
Downstream, poverty wages and the retrac-
tion of mill-subsidized housing had created a health
crisis. In 1882, the Lowell Board of Health reported
that the French-Canadian neighborhoods of Little Ca-
nada were an “unwholesome quarters” where “sanitary
30 Le Travailleur was a French-Canadian newspaper based in Worcester, Massachusetts. Massachusetts Bureau
of Statistics of Labor, "Resolve Relative to a Uniform System of Laws in Certain States Regulating the Hours of La-
bor," in Thirteenth Annual Report of the Massachusetts Bureau of Labor Statistics, chap. 29 (Boston: Massachusetts
Bureau of Statistics of Labor).
31 DavidVermette, A Distinct Alien Race, 207, 250. Notably, the degradation of working conditions at this time coincided
with an overall increasing population of immigrants in Lowell. Statistics compiled by the Lowell Board ofTrade report that 40%
of the city’s population circa 1916 was native born.The remaining 80% of residents were of either foreign or mixed heritage.
Lowell Board ofTrade, Digest of the City of Lowell and its SurroundingTowns (Lowell: Lowell Board ofTrade, 1916), 5.
32 Lowell Board of Trade, Digest of the City of Lowell and its Surrounding Towns, 116.
33 George Frederick Kenngott, The Record of a City: A Social Survey of Lowell, Massachusetts (New York: Mac-
millan Company, 1912), 68-71.
34 Yukari Takai, Gendered Passages: French-Canadian Migration to Lowell, Massachusetts, 1900-1920 (New
York: Peter Lang Publications, 2008), 50.
35 Statistics calculated from survey data. Children's ages ranged between 1 and 5. G. Frederick Kenngott, The
Record of a City: A Social Survey of Lowell, Massachusetts (New York: Macmillan Company, 1912), 68-71, 133-34.
36 Frederick Kenngott, The Record of a City: A Social Survey of Lowell, Massachusetts, 108.
37 Alfred Laliberté, "L’école paroissiale," in [Rev. Adrien Verette] La Croisade Franco-Americaine (Manchester,
laws [were] grossly violated. As a result, “many of these
innocents [have] died from lack of nourishment, care,
cleanliness, and pure air.”33
Two years prior, the Lowell
Daily Citizen described the city as having “the finest
mills and the dirtiest streets," marked by foul odors
and animal matter. In 1881, a physician visiting Litt-
le Canada found “the family and borders in such close
quarters, that the two younger children had to be put to
bed in the kitchen sinks.”34
At this time, Lowell’s Little
Canada constituted the second densest neighborhood
in the country after Ward 4 of New York City.The pre-
carity that French-Canadian immigrants experienced
was most evident in their heightened mortality rates;
between 1890 and 1909 the likelihood of French-Ca-
nadian children passing away before the age of 5 ranged
from 14% to 18% compared to 3% for native children.
In 1890, adult French-Canadians experienced more
than double the 15% mortality rate of their non-immi-
grant counterparts. The stakes for mutual aid societies
in Lowell were demonstrably high.35
Shared culture was the foundation for facilitating
intra-community relief in Lowell. By 1880, French-Cana-
dians in New England had founded 63 parishes, 73 natio-
nal societies, and 37 French-language newspapers, often
directly and indirectly involved with charitable causes. By
1908, 133 parochial schools attending to 55,000 students
had been instituted.36
As the artist Alfred Laliberté has ar-
ticulated:“the parish school remains the cornerstone of our
national survivance in the United States.We can have pari-
shes,societies,newspapers,and efforts of all kinds,but if our
children do not attend parochial schools, we [will] lose all
that.”Survival was a matter both literal and cultural.37
8
THE FRANCO-AMERRICAN ORPHANAGE

Interestingly, Little Canada was an enclave no-
table for its French-Canadian roots and internal de-
mographic diversity. Yukari Takai (2008) finds that the
neighborhoods attracted workers of various backgrounds;
a former resident recalled, “Everyone spoke French, in-
cluding several families with names such as O’Beirne,
O’Flahavan,Moore,Murtagh,Thompson,O’Brien,Lord,
Sawyer, Thurber, Sigman, Tumas, Protopapas, Brady,
and Grady.”38
It is this complexity—that the city was a
place where immigrants could affirm their identities, be
absorbed into other identities, and one where cultural he-
terogeneity was celebrated among the workers—which
offers a glimpse of a multicultural ideal specific to Lowell.
Before instituting the FAO, the Grey Nuns were certain
to include the clause: “while the orphanage is essentially
Franco-American,we will not exclude other nationalities.”
Children from Italian,Irish,and Syrian backgrounds were
accepted throughout the subsequent decades.39
Indeed,
the development of the FAO as a mutual aid organization
was in many ways the mirror inverse of restructuring that
occurred at the state level.The orphanage was established
to be specifically French-Canadian and later expanded to
cater for a more general, diverse population; Massachu-
setts policymakers, on the other hand, worked to restrict
access to more specific and narrowly defined categories of
paupers.American relief,in this way,has historically been a
site of contestation and contradiction.The FAO may have
been the pride of French-Canadians, but it was also a re-
source made deliberately available to anyone who needed it.
N.H.: L’Avenir National, 1938), 256.
38 This was likely because of Little Canada's proximity to local mills. Takai, Gendered Passages, 55.
39 "Correspondence of Grey Nuns 1908" Box 1 in Franco-American Orphanage/School collection at the Center
for Lowell History; "Admission records," Box 4 of Franco-American Orphanage/School collection at the Center for
Lowell History.
40 "Compter de l’Année," Box 3 Franco-American Orphanage/School collection, Center for Lowell History.
41 The FAO remained at full occupancy every year between 1908 and 1932. There was an expansion of the or-
phanage's facilities in 1913 that can account for a surge in orphans cared for by the FAO. This coincided with both a
deadly pandemic and the first world war; Statistics calculated by author from admission records 1908-1932. "Admission
Records," Box 4 Franco-American Orphanage/School collection, Center for Lowell History.
42 To further the conversation on industrialization and immigration as interrelated processes, it is worth noting
HE FAO CAN be conceptualized as both
a mutual aid society and an agency opera-
ting on behalf of the emerging welfare state.
As early as 1910, the FAO received funding
from the Massachusetts Bureau of Charity that ranged
between $300 and $700 annually and amounted to ap-
proximately 1-2% of the orphanage’s income. Between
50-80% of the institution’s revenue was derived from
“child’s pensions”paid by the orphans’families. Payment
varied according to means; of the 291 children in 1920,
188 paid $3 per week,84 paid $2.25,and 19 paid nothing.
As stipulated in the Grey Nuns’contract,“if an unknown
orphan is admitted to the orphanage, Monsieur le Curé
of [St. Joseph’s] parish would pay his pension […] to be
reimbursed by the parishioners.” Contributions through
Oeuvre du Pain,the fundraising initiative,peaked in 1923
at $5,567.12 and dropped to an all-time low of $99.55 in
1933.40
Orphan families, the French-Canadian commu-
nity,and the state of Massachusetts account for the FAO’s
survival at a time of economic recession and depression.
The term “charity”ascribed to the orphanage understates
both its proximity to the state and the contributions of
ordinary people to its success.
A statistical analysis of the FAO’s admission
records dating 1908 to 1932 further illuminates the
institution’s role in the community. Information inclu-
ding the orphan’s birthday, parental occupations, home
address, ethnicity, date of entry, and date of departure
was dutifully recorded by the Grey Nuns when avai-
lable.41
As depicted in Figure 1.1, most orphans had
French-Canadian heritage despite minor diversification
in the 1920s. Between 1908 and 1920, a considerable
97% of orphans were French-Canadian compared to
85% between 1920 and 1932. Figure 2.1 examines the
representation of orphans from industrial cities, with
exactly 69.7% from Lowell and the remainder with ties
to Lawrence and Haverhill. In total, 94% of children
were born in Massachusetts.42
ORPHANS WERE
NOT PARENTLESS
Inside the Franco-American
Orphanage
T
9

Demonstrated in Figure 3.1, the plurality of
parental occupations for children at the FAO were mill
workers and journaliers (“day workers”). Most interes-
tingly, the 3% of orphans with “none”parents—including
those listed as “dead,” “unknown,” or “unemployed”—re-
veals that 97% of orphans, the overwhelming majority,
had living and working parents.43
The documented du-
rations-of-stay for orphans at the FAO, depicted in Fi-
gures 4.1 and 4.2, bolster this discovery. Between 1908
and 1932, over half—55%—of children were dropped off
and picked up within the span of a year. Approximately
78% of orphans resided at the FAO for less than 3 years.
The average length of stay was 21 months compared to
the median of 9 months. Most orphans at the FAO (a)
had living,working parents,(b) were financially supported
by their families, and (c) returned to their families after a
temporary leave. This is a reconceptualization of what it
meant to be an orphan in the early 20th century.44
In the case of a Syrian workman,George Alias,a
decision was made to keep his son Philippe and daugh-
ter Eva at the orphanage for 22 days. Edmund Pinard,
a carpenter in a nearby neighborhood, dropped off and
picked up his son Joseph three times between 1926 and
1931. The three sons of Emile and Rose Duchanne, si-
milarly, stayed for a two month stretch in 1930 and for
a four-month stretch the same year. Parents, it is clear,
were not abandoning their children. The FAO provided
a service for surviving industrial life.45
HE FAO IN Lowell was an organization
inseparable from its industrial context.
This paper’s discovery that orphans were
supported by families and given tempora-
ry reprieve at the institution can reconceptualize the
that the mill cities of Haverhill, Fall River, Lawrence, and Lynn were locations with large immigrant populations; "Admis-
sion Records," Box 4 Franco-American Orphanage/School collection, Center for Lowell History.
43 Journaliers worked primarily in seasonal and temporary job. Additionally, between 1908 and 1932, only 22
children were placed into adoptive care. This was primarily to other family members. "Admission Records," Box 4 Fran-
co-American Orphanage/School collection, Center for Lowell History.
44 "Admission Records," Box 4 Franco-American Orphanage/School collection, Center for Lowell History.
45 "Admission Records," Box 4 Franco-American Orphanage/School collection, Center for Lowell History.
46 C.L., "Little Canada," oral interview, May 3, 1975, typewritten transcript. Center for Lowell History, French-Ca-
nadian Oral Histories, 5, 22.
47 Richard Santerre, La Paroisse Saint-Jean-Baptiste et les Franco-Americains de Lowell, Massachusetts, 1868-
1968 (Manchester, N.H.: Editions Lafayette, 1993), 43-44.
meaning of early 20th century charity. The FAO is
analogous to contemporary systems of mutual aid and
can demonstrate the indirect, localized mechanisms
by which the Massachusetts state distributed relief.
The myth of orphanages as repositories for abandoned
children remains an outdated stigmatization of wor-
king-class parents; indeed, this paper outlines the
ways in which orphanages were resources created by
neighborhoods in collaboration with each other. Fur-
thermore, the centrality of immigrant identity—both
as the framework for organizing within working com-
munities and as a site of backlash by nativist intel-
lectuals—to the development of American welfare is
posited to be a significant dimension of analysis and
one that merits future research.
The FAO is proof of the interdependent rela-
tionships that defined the French-Canadian community
in Lowell.As has been articulated by a former resident of
Lowell’s Little Canada:
The Population was so big in Little Canada that the
blocks were real[ly] close. But all families got along beau-
tiful[ly] and we were all French people. […] Everybo-
dy helped everybody, which is not done nowadays like it
was then, but people that had the money—if one needed
help that means they would get together and they would
come over and help. [...] If you look back to it, I still think
I’d like to be there.46
The FAO demonstrates the self-determination
of French-Canadians within a context of structural
inequality. As Richard Santerre (1993) has put into
words, “people found emotional sustenance, psycho-
logical security, and a sense of meaning in Little Ca-
nada of the late 19th and early 20th centuries.” This
meaning and security was built from the bottom up by
working families.47
CONCLUSION
T
10

Figure 1.1 Orphan Ethnicities
1908-1912 1913-1917 1918-1922 1923-1927 1928-1932 % Overall
384 1010 703 550 473 96.0% Fr. Canadian
0 11 10 11 20 1.6% Irish
0 0 3 35 10 1.4% American
0 15 15 59 33 0.1% Italian
4 17 6 76 63 3.9% Other
The “Other” category represents the small number of Syrian and Belgian children at the orphanage. [5]
Figure 2.1 Top City Origins of Orphans
1908-1912 1913-1917 1918-1922 1923-1927 1928-1932 % Overall
277 627 634 404 311 69.7% Lowell
11 93 4 19 15 4.4% Lawrence
14 24 12 47 10 3.3% Haverhill
1 13 4 31 57 3.3% Salem
4 43 12 8 33 3.1% Lynn
8 6 5 22 7 1.5% Boston
[6]
Figure 3.1 Top Parental Occupations of Orphans
1908-1912 1913-1917 1918-1922 1923-1927 1928-1932 % Overall
136 249 109 142 106 36.1% Mill workers
121 189 75 42 72 24.2% Day workers
16 57 37 22 24 7.6% Machinists
22 24 23 31 16 5.6% Carpenters
8 33 11 32 16 4.9% Shoemakers
8 21 6 12 18 3.2% Painters
0 21 7 9 27 3.1% Clerks
2 7 6 21 5 2.0% Metalsmiths
1 5 3 12 18 1.9% Drivers
13 2 3 23 25 3.2% None
“Day Workers” consisted of seasonal and temporary laborers, primarily working in mills, construction, and
agriculture. The “None” category signifies the number of parents designated as “absent,” “unemployed,”
“sick,” “deceased,” or "handicapped." Note: not all parental occupations are represented on the table. Other
professions include electricians, grocers, farmers, bakers, barbers, and plumbers. [7]
11

Figure 4.1 Length of Stay at Orphanages (Percentages)
1908-1912 1913-1917 1918-1922 1923-1927 1928-1932 Total
5.2% 14.9% 13.8% 8% 8.9% 10.6% 5+ years
0.6% 8.6% 18.5% 10.3% 14.9% 11.6% 3-5 years
21.4% 4.8% 32.5% 24.5% 28.1% 22.7% 1-3 years
14.5% 8.3% 11.8% 18.7% 14.5% 13.7% 6-12 months
17.9% 14.3% 6.3% 15.7% 12.3% 12.7% 3-6 months
41% 49.5% 17.5% 23% 21.7% 28.6% <3 months
[8]
Figure 4.2 Length of Stay at Orphanage (Mean and Median)
1908-1912 1913-1917 1918-1922 1923-1927 1928-1932 Total
11.2 20.4 28.4 19.7 21.6 21.4 Mean
3 3 21 9 12 9 Median
Units in months. [9]
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[1] Box 12 of Franco-American Orphanage/School
14

SPRING 2021
TECHNOLOGY AND
PARADIGM
The X-Ray,Electrical Therapeutics,and the Consolidation of Biomedicine
by Libby Hoffenberg, Swarthmore College '20
Written for an interdisciplinary honors thesis in History and Philosophy of the Body
Advised by Professor Timothy Burke
Edited by Daniel Ma, Gabby Sevillano, and Katie Painter
An 1897 setup for taking an x-ray of the hand. [1]
15

N NOVEMBER OF 1895, physicist Wil-
helm Röntgen discovered a wavelength of
electromagnetic radiation that came to be
known as the “x-ray” or the “Röntgen ray.”
Within months, experimenters and laypeople were pro-
ducing x-ray images using a simple set of machinery. In
order to make an x-ray exposure, one needed just three
elements: a current source, a Crookes tube, and a pho-
tographic plate.1
Although the process was relatively
simple, material limitations made the apparatus brea-
kable, bulky, and unreliable. Historians have referred to
this phase of the x-ray’s existence as the “gas tube era,”
which more or less ended in 1913 when stronger and
more versatile equipment was developed.2
The unwieldiness of the x-ray machine as a phy-
sical object mirrored its clumsy implementation in va-
rious medical and non-medical enterprises. The x-ray
was regarded with fascination as a device that clearly did
something—it “miraculously” revealed the body’s inte-
rior and produced outwardly observable effects on the
body—but it had ambiguous uses and meanings. It was
entertained as a therapeutic tool in treating everything
from blindness to cancer,3
a photographic novelty that
produced chic and “coquettish” images of women of
means,4
and a way to substantiate prosecuted criminals’
claims to insanity,5
among many other uses.
Historians have duly noted the dramatic public re-
ception of the x-ray, as well as many of its initial experi-
mental applications.Theorists in visual studies particularly
emphasize the public’s reaction to the x-ray as “spectacle”
and the capitalization of novelty by professionals of various
standings to substantiate their authority. This interpreta-
tion importantly complicates teleological narratives of the
x-ray and articulates the multiple and unstable significa-
1 Matthew Lavine, "The Early Clinical X-Ray in the United States: Patient Experiences and Public Perceptions," in
Journal of the History of Medicine and Allied Sciences 67, no. 4 (Oxford: Oxford University Press, 2011), 590.
2 Richard F. Mould, A Century of X-Rays and Radioactivity in Medicine: with Emphasis on Photographic Records of
the Early Years (London: Institute of Physics Publishing, 1993), ch. 5.
3 "Wonderful X RayTests: Blind Man SeesThroughTop Of His Own Head," Chicago DailyTribune, January 2, 1897, 14.
4 "Her Latest Photograph: It Is An Electrical Picture," New York Times, May 29, 1898, 14.
5 "Electricity Consumption: The New Treatment Of Phthisis By The Use" Los Angeles Times, September 5, 1897, 16.
6 See Lisa Cartwright, Screening the Body: Tracing Medicine's Visual Culture (Minneapolis: University of Minne-
sota Press, 1995); Joel D. Howell, Technology in the Hospital Transforming Patient Care in the Early Twentieth Century
(Baltimore: Johns Hopkins University Press, 1995) for analyses of the x-ray’s implication in public visual culture and the
development of the 20th
century hospital, respectively.
tions of a new technology.It upends the idea that the x-ray
was,from its inception,destined to claim the authoritative
place it holds in current healthcare practices. It affirms
that technologies do not arise in response to pre-existing
needs,but they become institutionalized by and in service
of contingent relations of power.6
Most histories of the x-ray, however, consider its
development as a diagnostic screening tool and fail to
consider, or make only cursory reference to, its use as a
therapeutic agent. These accounts obscure the epistemo-
logical complexities implied by the selection of the nas-
cent technology’s diagnostic use over its therapeutic one.
In this chapter, the narrowing epistemic field of the x-ray
is considered alongside the shifting contexts and contents
of American medicine.Across approximately the first half
of the twentieth century, multiple potentialities of the
x-ray were winnowed to a single diagnostic use just as a
modern scientific healthcare paradigm was emerging. In
other words, the x-ray technology and its symbolic power
evolved alongside changes in the knowledge practices
sanctioned by modern healthcare. The negotiation of the
x-ray’s potentialities can be contextualized by investigating
how the uses for the x-ray were entertained in a medical
context that was itself uncertain. Different philosophies,
metaphors,and interests were called upon to justify its pri-
vileged position as a device of specialized visibility.
While the x-ray was invented in Germany, many
novel uses of and deliberations over the technology took
place in American hospitals, journals, and other sites of
medical activity. The x-ray’s early days of use and expe-
rimentation—from its invention in 1895 until roughly
1940—reveal an unruly history that broadly parallels na-
vigations of ambiguity in the American medical system.
The x-ray moved through a series of epistemological and
professional paradigms, each of which shaped and were
shaped by x-ray practice. The x-ray debuted in a medi-
cal system that was largely constituted by idiosyncratic
doctor-patient relationships, which were themselves
INTRODUCTION
I
16
TECHNOLOGY AND PARADIGM

relatively closed worlds of therapeutic practice. In the
context of this testing ground,the x-ray proved amenable
to a number of explanatory frameworks, as eclectic prac-
titioners integrated the device into their own ideological
priorities.Many early practitioners understood the x-ray’s
therapeutic potential in relation to other therapeutic uses
of electricity, thus revealing the technology’s absorption
into vitalistic, or spiritualized, medical paradigms.
During the x-ray’s “middle years,” approximately
1900 to 1918, the technology assumed an aura of pro-
fessional appeal based on its capacity to authoritatively
image the body’s interior. At this time, the x-ray became
privileged for its capacity to produce certain scientifi-
cally verified images. The ascendance of the x-ray’s dia-
gnostic use sheds light on the growing primacy of visual
knowledge, and specifically of mechanically-produced
images, within medical practice.
In its post-WWI years, the x-ray became embedded
in large industrial-scientific medical institutions. It was in
this context of broad redefinitions of healthcare that the
x-ray assumed its diagnostic legitimacy, taking its place
alongside a host of other organizational and information
technologies that tethered together the practices of different
physicians into a single system.At this time,healthcare was
increasingly reconfigured as a business that was premised
on the modern individual’s health-seeking efforts.The x-ray
helped to produce the notion of the body as a site of conti-
nual maintenance,as it made the authoritative visualization
of the body’s interior a coordinating principle for diagnostic
activity. Esteemed medical professionals increasingly aug-
mented their medical judgment with the x-ray’s technolo-
gically-advanced capacity to objectively discern the most
fundamental structures of any individual.
HE X-RAY EMERGED at a moment
of confusion about how best to govern the
body. In the latter part of the nineteenth
7 P.Thomas, “Homeopathy in the USA," in British Homeopathic Journal 90, no. 2 (NewYork:Thieme, 2001), 99-103.
8 James C. Whorton, Nature Cures: The History of Alternative Medicine in America (Oxford: Oxford University
Press, 2002), 18.
century and into the early twentieth century, the set
of possibilities for this governance was expansive. The
American medical community was actively deliberating
between different paradigms for understanding and
treating the body. A representative, though not com-
prehensive, example of the uncertainty regarding me-
dical paradigm was the dispute between allopathic and
homeopathic philosophies of care.The tensions between
the two illustrate the emergence of an ideologically
bounded modern medicine, in relation to which other
paradigms would be relegated to the domain of “alter-
natives.” Homeopathy and allopathy coordinated their
professional activities against one another: the American
Medical Association formed in 1847 in response to the
organization three years prior of the American Institute
of Homoeopathy.7
And, increasingly, regulatory pro-
visions were made to silo the fields from one another:
written into the AMA charter was a consultation or ex-
clusion clause, meaning that an orthodox doctor could
not consult with a homeopath or help a patient who was
under concurrent treatment by a homeopath.
“Allopathy” was and remains a somewhat conten-
tious term. It was coined by Samuel Hahnemann, the in-
ventor of homeopathy, in 1807, to designate the opposing
ideologies underlying the two medical practices. Homeo-
pathic practitioners operated under the principle that “like
cures”would cure “like symptoms.”They believed that mi-
nute concentrations of a particular toxin would cure the
symptoms that the same toxin produced in larger doses.
Allopathic practitioners, on the other hand, prescribed
cures that opposed the observed symptoms. They sought
out substances that would counteract the toxins believed
to be causing patients’ ailments.8
Hahnemann used the
word “allopathic” to denigrate antagonistic remedies that
he believed could only address symptoms and would ine-
vitably fail to treat the underlying disease.
Homeopathy and allopathy existed alongside one
another in the nineteenth century and into the twen-
tieth century,showing that not only were particular cures
being deliberated, but the very idea of what constituted
a cure was uncertain. The debate between paradigms of
care reflected disputed assumptions about what kinds of
substances or forces could act on the body to move it
closer to health.The way that a body was seen to respond
to forces and substances in turn reflected prevailing ways
T
MEDICINE
BEFORE
BIOMEDICINE
17

of understanding the physical makeup of the world. In
charting the unruly history of the x-ray across medical
paradigms,different justifications for its use appear in re-
lation to shifting ideas about the constitution of the ex-
ternal world.The ways in which the x-ray is and has been
authorized in medical practice reveal much about the
assumptions that structure the practice of medicine.Me-
dicine is a space where ideas about the world are concre-
tized in bodies, and in the social and material relations
that produce health and sickness. In tracking the way
that certain explanatory paradigms take precedence over
others, one can situate the priorities of medicine within
a vast and contingent field of knowledge production and
recognize the tensions that lie within it.
N ASKING HOW practitioners made
sense of the x-ray’s potentialities in the
context of prevailing understandings of the
world around them, it is helpful to look at
the paradigms that shaped the x-ray’s early development.
Historians of the x-ray have noted that practitioners of
the new device drew on metaphors of light, as they “illu-
minated” the interior of the body.The public would have
been familiar with a number of other light therapies that
existed at the time, including the Finsen light, the light
bath, and a light bulb that would literally illuminate one’s
body from within.These often unorthodox electrical the-
rapies challenge the device’s reputation as a squarely mo-
dern scientific tool. As a therapy that is continuous with
both ‘occult’ traditions and distinctly modern ideas about
causality,the potency of the x-ray could be situated in see-
mingly contradictory ways of understanding the world.
Uncertainty about the x-ray was in part mitigated
by the American public’s familiarity with electrical thera-
peutics.The x-ray was new in its ability to produce pho-
tographic plates of the body’s interior, but the concept
9 Lisa Rosner, "The Professional Context of Electrotherapeutics," Journal of the History of Medicine and Allied
Sciences 43, no. 1 (Oxford: Oxford University Press, 1988).
10 Linda Simon, Dark Light: Electricity and Anxiety from theTelegraph to the X-Ray (Orlando: Harcourt Books, 2004),
11.
of using electricity for medical therapies was not new. In
addition to general public interest in new applications of
electricity—newspapers featured regular columns on re-
cent developments in all things electrical—medical pro-
fessionals had been experimenting with “electrotherapy”
for much of the latter half of the nineteenth century.9
Electrotherapeutics denoted a broad set of techniques
used to run an electric current through a particular part
of the body. The term was utilized by practitioners with
a range of professional standings and was applied to a
large array of technologies and apparatuses. Electrothe-
rapeutic textbooks were published, colleges inaugurated,
and journals convened, indicating that electrotherapy
consisted of a fairly well-defined set of practices, coordi-
nated by particular rationales for their use.
Developments in electrotherapeutics were part of a
long history of fascination with vital forces.Natural philo-
sophersthroughoutthenineteenthcenturywereconcerned
with identifying an animating force that would explain the
aliveness of living things in the context of a purely physi-
cal world. Vitalism, broadly defined, was this quest for a
single life energy. The term “electrics” was coined in the
sixteenth century in the context of naturalists’ “predilec-
tion to sustain this notion of a life-giving energy,”10
and
was used variously to talk about gravity, magnetism, and
electricity. These mysterious forces were weightless and
invisible, yet they could act on living matter. Theorizing
the relationship between these forces and the human body,
Sir Isaac Newton proposed that this ethereal substance
also imbued nerves. Modifying Descartes’ understanding
of the nerves as hollow tubes through which vital spirit
flowed,Newton supposed,rather,that nerves were solid fi-
laments that produced Animal Motion through vibration.
This modified theory led eighteenth-century scientists
to demonstrate the affinity between “artificial electricity”
and “animal electricity”—the former externally-produced
and the latter intrinsic to animate beings’ physiological
makeup. A singular substance was understood to course
through both living bodies and the external world; this
was the mechanism whereby qualities of the external wor-
ld animated the human body.
In addition to being a pragmatic way to make
sense of how forces inside the body were related to forces
outside the body, electricity was also useful in thinking
I
ELECTRICITY
AND VITALISM
(1895-1900)
18

through the connection between different parts of the
body. Around the turn of the century, medical practitio-
ners were theorizing the body as an integrated whole,
coordinated by some set of unifying processes.11
Howe-
ver, even prior to advances in fields like psychotherapy
and endocrinology—both of which are based on theories
of homeostasis in the body—electricity was used to
conceptualize the way the body was harmonized. James
Miller Beard,a neurologist and contemporary of Edison,
popularized the term “neurasthenia”in 1869 as a disease
that caused depression and anxiety in modern, intelli-
gent people with fast-paced urban lives. In the paradigm
of neurasthenia, the nervous system and electricity were
closely related both causally and conceptually. Beard
theorized that electricity was one of the reasons indi-
viduals might develop neurasthenia, as electricity was a
prominent feature of modern urban life; those living in
cities could not escape the stimulation that was induced
by constant artificial light.12
Electricity also allowed
Beard to theorize the relationship between mental states
and physiological activity through the nervous system,
which was increasingly understood as the intersection of
body and brain.13
As in both psychotherapy and endocri-
nology,neurasthenia conceived of a relationship between
mental states and the chemical or physical makeup of
the affected individual’s body. Electricity enabled Beard
to describe this movement between the material and the
immaterial. Electricity seemed to coordinate the activity
of the outer and inner worlds, generating bodily effects
from non-living external objects.
The effects of electricity on the body could be
understood within the frameworks of both scientific
medicine and unorthodox therapies. As electrotherapy
became a popular modality, Beard supposed that elec-
tricity could be used to cure neurasthenia.14
Although
Beard was a noted skeptic of spiritualism, the idea that
electricity could be simultaneously a cause and a cure for
neurasthenia accorded with the homeopath’s assump-
tion that the cure could be the same as the cause of a
disease. Beard’s theory gained respectability for its focus
11 Stefanos Geroulanos and Todd Meyers, The Human Body in the Age of Catastrophe: Brittleness, Integration,
Science, and the Great War (Chicago: The University of Chicago Press, 2018).
12 Simon, Dark Light, 6.
13 Beatriz Colomina, X-Ray Architecture (Baden, Switzerland: Lars Müller Publishers, 2019).
15 Dr. E. J. Fraser, Medical Electricity: a Treatise on the Nature of Vital Electricity in Health and Disease, With plain
Instructions in the uses of Artificial Electricity as a curative agent (Chicago: S. Halsey, 1863).
16 Helena Petrovna Blavatsky, The Theosophical Glossary (London: The Theosophical Publishing Society, 1892),
13. Theosophy was an occultist religious movement begun in America in the late 19th
century.
on electricity as a feature of the modern world; it was
credible to many who sought scientific explanations for
the perceived effects of electrical devices. But it was also
situated well within theories of causation that would
soon be understood by allopathic medicine as primitive
and unscientific.
Electrotherapeutics appealed to the mysterious
mediation of electricity between artificial and natural
entities in the world. Practitioners of electrotherapeu-
tics justified their modalities in ways that called upon
electricity’s affinity with vital forces in the public imagi-
nation. An 1863 pamphlet published by Dr. E.J. Fraser,
who designates himself a “practical medico-electrician,”
is entitled “Medical Electricity: A Treatise on the Na-
ture of Vital Electricity in Health and Disease, With
plain Instructions in the uses of Artificial Electricity
as a curative agent.”15
Another pamphlet, this one from
1891, is entitled “Ethereal Matter, Electricity and Aka-
sa.” Akasa, or Akasha, is a Sanskrit word that means
“space”or “sky,”and in Theosophical understanding was
seen as a spiritual primordial substance that pervades
all of existence.16
The pamphlet’s contents include in-
formation on new devices to detect “different condi-
tions of ethereal matter,” “something new about the
human organism,”“transmission of ideas to a distance,”
and “occult tricks.”
Vital forces were understood to operate in a hu-
man organism governed by both physiological and men-
tal states.The title page of a 1903 publication by the Phy-
sico-Therapeutic Institute indicates that electricity was
a candidate, alongside “water, air, heat, light, movement,
ozone, oxygen, carbonic acid, etc.,” for treating a num-
ber of conditions that were neither wholly physical nor
wholly mental. The same title page features a quote by
D.J. Rivieré, the publisher of the pamphlet (who did not
indicate any professional credentials): “The object of the
physico-therapeutic cure is to raise the nervous function
when depressed, to put right the trophic functions when
out of order. It raises the chemical activity of medicines
and it insures the organic eliminations necessary to the
19

regular purification of the Economy.”17
Rivieré appeals
to discourses of chemistry, neurology, physiology, and
hormonal (“trophic”) functions to justify his therapeu-
tic method.These multiple discourses, as well as his des-
cription of the body as an “economy,” reveal the impulse
within the medical community to theorize health and
sickness as involving the equilibrium of the entire orga-
nism.Electricity provided a pivot from vague understan-
dings of the body based on the harmonization of its parts
to scientific medicine’s updated models of homeostasis
based on biochemical entities. Electricity connoted the
vital force that coordinated activity but was also distinc-
tly modern, a powerful tool with vast potential to know
the world in ever more precise ways.
17 D. J. Rivieré, Annals of Physico-Therapy (Paris: Physico-Therapeutic Institute of Paris, 1903).
18 Herbet Robarts, The American X-Ray Journal 1, no.1 (1899).
19 Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health "200 Years
of American Medicine (1776-1976)," an exhibit at the National Library of Medicine.
Electricity was an enticing cure for a medical com-
munity that was actively deliberating over the proper way
to treat sick bodies. The flexible ontologies underlying
electricity authorized its use as a therapeutic modality
in both allopathic and homeopathic practices. The de-
bate between allopathy and homeopathy as the most
appropriate medical system roughly mirrored the de-
bate between those who thought that diseases ought to
be cured by treatments administered externally from the
body and those who believed that the disease’s natural
course of development in the body would cure the pa-
tient. Allopathic practitioners sought different kinds of
substances to administer to the body, while homeopaths
supposed that the body naturally stored the entire phar-
macopeia of substances it could need. Allopaths tended
to celebrate the variety of pharmaceutical compounds
that were being synthesized or discovered with increasing
frequency. New therapies presented new tools to combat
disease. Homeopaths tended to criticize the search for
new compounds. Medical pamphlets and journals fea-
tured both drug advertisements and polemics,written by
and for doctors, against the use of drugs in medical care.
In this space of contradictory mindsets, electricity could
be configured as both external and internal; it was inte-
gral to the matter of the natural world but also existed
innately within the living body.
The x-ray’s continuity with electrical modalities
meant that its therapeutic potential could be justified
by appeals to vitality and energy. The x-ray’s association
with vitalism is evident in looking at the cover of the first
issue ofThe American X-Ray Journal.This journal began
in May 1897 with the stated intention “to give to its rea-
ders a faithful resume of all x-ray work.”18
The American
medical field saw an increase in the number of published
medical journals in the nineteenth century as physicians
returned from graduate training in Austria and Germany.
They grouped themselves into professional associations
and consolidated their reports of clinical and laborato-
ry research in medical publications.19
However, even as
x-ray practitioners began to coalesce around professional
organizations,they did not abandon the vitalistic conno-
tations of the x-ray. The cover of the first issue of The
American X-Ray Journal depicts a figure administering
the x-ray to the globe from outside the globe, indica-
The cover of the first issue of The American
X-Ray Journal. [2]
20

ting that the x-rays were seen to come from a mysterious,
non-earthbound, place. The spiritual connotations of a
figure floating above the earth connotes the idea of an
immaterial substance that animates the physical world,
flowing freely between living and non-living matter.
ISTORIANS HAVE NOTED the uti-
lity of the x-ray in consolidating the pro-
fessional authority of allopathic doctors
and radiological specialists—those in fields
that would later professionalize in relation to the x-ray’s
diagnostic capabilities.However,there has been conside-
rably less attention given to the way that non-allopathic
practitioners justified their authority through the x-ray,
often continuing to use the machine for non-diagnostic
purposes.After the x-ray had been wrangled as a specifi-
cally medical instrument,but before it became a standar-
dized diagnostic tool, various medical sects incorporated
the technology into their practices as a method of legiti-
mization. This period—approximately the first ten years
of the twentieth century—represents a middle space in
the x-ray’s early years that corresponds to the shifting
context of professional medicine.
Historians have noted practitioners’ self-legitima-
tion through the use of the x-ray, as the device came to
symbolize advanced scientific medicine. However, they
have not engaged with the particular nature of this sym-
bolism—the specific capacities that made the x-ray au-
thoritative. The invocation of the x-ray’s authority by
non-allopathic practitioners (those who would not go on
to coordinate their activities in relation to this authority)
shows that the regard given to the technology was not
solely a response to its association with the kind of scien-
tific biomedicine that would go on to dominate health-
20 "Electro-Therapeutics," Chicago Daily Tribune, July 23, 1899, 30.
21 Herbet Robarts, The American X-Ray Journal 1, no. 2 (1899), 30.
care. Rather, its authority was premised on its ability to
produce objective scientific images. Even when homeo-
pathic practitioners used the x-ray in therapeutic vitalis-
tic contexts,they legitimized their practice by recourse to
the x-ray’s privileged capacity for visualization.
After the x-ray had become widely known to the
general public,but before it attained its diagnostic role in
institutionalized biomedicine,it was seen as the most au-
thoritative form of electrical healing. An 1899 article in
the Chicago Daily Tribune chronicles the moment the
x-ray became a privileged electrical therapy. After ex-
pounding the various specialties in which electricity was
useful and effective “in the hands of a skilled physician”
—dentistry,medicine,surgery,cauterization,thermal and
chemical effects—the author laments the hindering of
the field’s development at the hands of “quackery prac-
ticed in early days.”20
The authority of “regular practitio-
ners,”he says,was threatened by individuals who peddled
products like electric belts and electric hairbrushes. The
author then suggests that legitimate practitioners, who
previously refrained from publicizing electrical therapies,
were becoming louder voices in the field.This “change in
public sentiment,”he suggests,“[is] greatly stimulated by
the discovery of the X ray by Baron Röntgen.” This ar-
ticle also affirms that the x-ray was not considered a dis-
tinctly new kind of machine. Articles in The American
X-Ray Journal even continued to refer to the x-rays as
“vibrations,” indicating the x-ray’s continued association
with a broader set of other electro-therapeutic machines.
An article in the same journal states that the x-ray had
“brought more forcibly before the minds of physicians
the value of the electric current as a therapeutic agent.”21
The x-ray, then, was beneficial not only in consolidating
the authority of scientific medicine, but also in justifying
the continued use of electrical therapeutics.
The x-ray, out of all other electrical therapies, be-
came associated with advanced scientific medicine be-
cause it was the only electrical therapy that produced
an image. The x-ray’s image-making capacity makes it a
case study for the history of modern scientific medicine’s
self-legitimation through the technique of specialized
perception. In the eighteenth century, the epistemically
authoritative gaze helped to standardize the interpreta-
tion of the body’s interior, so that medical professionals
could amass a stable body of knowledge about anato-
H
MECHANICAL
OBJECTIVITY
AND THE
DOCTOR-PATIENT
RELATIONSHIP
21

mical structures that were beyond the reach of ordinary
perception.22
After the prior sanction against dissection
was lifted,practitioners revealed and recorded the typical
structures that existed below the surface of an individual’s
symptoms and experience, thereby decreasing the need
for the patient’s own narrative and symptomatology.
Doctors’ordinary sight was augmented by a professional
vision that relied upon the delineation of ideal types.
The x-ray capitalized on the deep legacy of scien-
tific visuality while also benefiting from the technology’s
affinity with photography. Photography, which was in-
vented 60 years before the x-ray,both allowed for “objec-
tive” images to be produced mechanically and increased
the number of images that individuals encountered,
thereby contributing to a visual culture that associated
knowledge with sight. The x-ray became authoritative
because it could reveal the structure or ideal type—the
skeleton—beneath the surface of the patient’s skin and
could do so objectively. An early manual that delineates
the parts of the x-ray machine and its potential use in
surgery is subtitled “Photography of the Invisible,” im-
plying that the technology helped to produce legitimate
ways of seeing, and thereby knowing, what was beneath
the surface of the body.23
Use of the x-ray was justified by its capacity to vi-
sualize the body’s interior, even when it was not being
used for diagnostic purposes. Rather, the x-ray’s associa-
tion with scientific visuality allowed its continued use in
multiple non-allopathic and non-scientific contexts. A
feature in The American X-Ray Journal registers a mo-
ment in which the vitalistic powers of the x-ray were
called upon, even while the technique was also being
valorized for the objective qualities associated with mo-
dern scientific vision. An issue from March of 1898 fea-
tures an article entitled “Is There a Relationship Exis-
ting Between The X-Ray and the Luminating Power
that Obtains in Telepathic Vision?”written by a “J.J. Fly,
M.D.”24
(There were not rigorous standards for medical
school at the time,nor would it have been unheard of for
a non-doctor to claim medical credentials in the press,so
the professional standing of the author is open to ques-
22 Michael Foucault, The Birth of the Clinic: an Archaeology of Medical Perception (London: Tavistock Publications
Ltd., 1973), xii.
23 William James Morton, The X-Ray; Or, Photography of the Invisible and its Value in Surgery (New York: Ameri-
can Technical Book Company, 1896).
24 J.J. Fly, "Is There a Relationship Existing Between The X-Ray and the Luminating Power that Obtains in Tele-
pathic Vision?" in American X-Ray Journal 1, no. 5 (1898), 268.
tion).The article narrates what the author considered to
be the four great stages in the discovery of the qualities of
light,with the last one being the x-ray.The forms of light
discerned move “from the coarser to the finer, from the
ordinary to the inordinary,”so that the x-ray was seen as
a culminating “pulsating stream of ethereal atoms.” The
molecules of the latter forms of light were thought to be
farther apart so that the light could be compared to a gas
or liquid.This characterization of the x-ray recalls earlier
notions of electricity as a“fluid.”25
By describing the x-ray
in terms of its ethereal qualities,the author explained the
x-ray’s effects in vitalistic terms. In comparing the ray
to gas and liquid states, he portrayed it as a substance
that moves freely between bodies.However,this vitalistic
x-ray energy was simultaneously configured as scienti-
fically sophisticated. The x-ray, as an advanced stage in
the “evolution of the phenomena of light,” allowed the
“objective mind”to visualize what could not be seen with
the “natural eye.”The x-ray was called upon for its power
to augment everyday vision with a professionally-backed
scientific sight.
It is not clear what exactly the author saw as the
possible relationship between the x-ray and telepathy.
However, he clearly recognized the symbolic potency
of the x-ray as an effective way to coordinate sight with
knowledge.The author asks early in the article: “How is
it that we know a thing? And how do we come to know?
What is knowing?”In his account of the history of light,
he articulates a form of knowing defined by the prio-
rity of the visual in its ability to impress knowledge from
the immaterial world onto the faculties of the mind.The
x-ray was seen as the most sophisticated iteration of a
revelatory light that was considered to act on the mind
itself. As medical professionals were theorizing the rela-
tionship between mind and body, between mental states
and physiology, the x-ray was both vitalistic enough and
scientific enough to authorize research into telepathy,
what might have easily been deemed a “quack”practice.
Having become squarely associated with the pri-
vileges of objective scientific visuality,the x-ray technique
was regarded as legitimate enough to explore suspected
22

relationships between invisible or difficult-to-visualize
entities in the world. The impulse might not have see-
med so unreasonable, given that Thomas Edison himself
thought that the x-ray would one day be able to read
people’s thoughts.26
What is important is that the author
justifies a practice based on thoughts or mental states,
things that could not be seen, by appealing to the x-ray’s
association with sight. The emphasis on sight becomes
even more clear when he cites the potential for the x-ray
to cure blindness, writing that “those who never knew
what the sensation of sight was like, have been blessed
for the first time in life with that knowledge.” Vision
and its intimate connection to knowing were repeatedly
called upon to legitimize the x-ray’s epistemic authority,
even when the relevant practices involved entities that
could not be visualized through the x-ray.
Visuality became associated with scientific ma-
nagement in the context of the shifting nature of the
doctor-patient relationship between the nineteenth and
early twentieth centuries. As visuality became a privile-
ged way of knowing the body, physical manipulations
and diagnostic tests became less frequently used.The en-
counter between the doctor’s body and the patient’s body
took a radically different form, as the doctor’s physicality
was diminished in favor of an objective diagnostic eye.
Foucault’s analysis of the role of the stethoscope in Birth
of the Clinic points to the way that the doctor-patient
interaction was assimilated into the nexus of knowledge
and perception inaugurated by the discovery of patho-
logical anatomy. While the stethoscope was a listening
device, it served to both diminish the amount of physi-
cal touch in the doctor-patient consultation (by making
hand palpitations obsolete) and enforce diagnosis based
on images of the ideal healthy body.27
The x-ray occu-
pied a similar role in the doctor-patient interaction, as
it allowed the doctor to incorporate the expert percep-
tion into the evaluation of the patient’s body. Doctors in
the early years of the x-ray’s use expressed both enthu-
siasm and trepidation over the way that the x-ray would
change their interactions with patients. The x-ray’s dia-
gnostic potential was immediately glimpsed, as doctors
noted the use of x-rays to detect fractures, particularly in
military contexts.While some doctors capitalized on this
opportunity to substantiate their medical expertise,some
26 Colomina, X-Ray Architecture, 132.
27 Foucault, The Birth of the Clinic, 184-7.
28 Lorraine Daston and Peter Galison, "The Image of Objectivity," in Representations 40 (Los Angeles: University
of California Press, 1992), 81-128.
expressed resistance toward using the x-ray for diagno-
sis,arguing that manipulations of the bone by hand were
more accurate.
The x-ray’s image-producing capacity was condu-
cive to the new role assumed by medical practitioners
in the early years of the twentieth century. Whereas
the doctor was previously an individual whose healing
powers were intimately related to his or her own phy-
sicality, around the turn of the century the doctor was
reconfigured as a detached interpreter of the body and
its processes.The shifting grounds of medical knowledge
were conditioned by changing notions of scientific ob-
jectivity. In the latter part of the nineteenth century, ob-
jectivity came to be defined against the dangerous and
even immoral subjectivity of the individual practitioner.
The scientist,who in the past may have been admired for
qualities of genius, inspiration, and interpretation, was
now instructed to censure his or her personal subjectivity.
Scientistswerecommandedto“letnaturespeakforitself,”
a refrain also commonly heard in discourses around the
early invention of photography. Images, in this scientific
context, were thought to be the least vulnerable to “sub-
jective intrusions,”and so became privileged signifiers of
the emerging non-interventionist objectivity.28
And like
the camera, the x-ray could purportedly generate images
without the polluting individuality of the practitioner.
These images would be important in both constituting
and symbolizing stable bodies of scientific knowledge.
Although early twentieth century x-ray practitio-
ners called upon the visual authority of the device, the
context in which they practiced medicine was still lar-
gely the medicine of the nineteenth century. Nineteen-
th-century medical practice in America was predomina-
tely constituted by individual encounters between doctor
and patient. There were few professional organizations,
little regulation of medical education, and no standar-
dized research protocols to speak of.The earliest volumes
of The American X-Ray Journal consisted of a miscellany
of anecdotes and curiosities about individual practitio-
ners and experiments. And, because the components of
the x-ray were easy to obtain, “practitioners” could re-
fer to individuals of variable professional standing and
with variable amounts of clinical medical experience.The
journal itself was part of a movement within medicine
23

toward professionalization, but its contents indicate that
knowledge about the x-ray as a medical device consisted
of an accumulation of isolated, ad hoc experiments.
NDIVIDUAL MEDICAL encounters
afforded practitioners their own particu-
lar notions of what constituted medical
knowledge. This epistemological idiosyn-
cracy changed in the twentieth century as the doctor-pa-
tient interaction became situated within larger systems.
Whereas treatments and protocols in the nineteenth cen-
tury were generated idiosyncratically between the physi-
cian and the patient, in the early twentieth century, this
epistemological space expanded to include a multitude
of specialists within complex hospital systems. Whereas
medical knowledge in the nineteenth century was gene-
rated through the doctor’s use of interpretive subjectivity
over a living body, in the twentieth century the “per-
ceptive act” moved “outside of heart and head and into
the information systems and professional organizations
that organize the bits of available knowledge and deve-
lop guidelines and clinical pathways that inform clinical
practices.”29
The doctor’s own mind and body were pre-
sent in x-ray experimentation, particularly as they were
predisposed to try out the new rays on their own bodies.
But between the nineteenth and twentieth centuries, the
shifting character of medical knowledge, and with it the
legitimation of the x-ray as a producer of images, was
personified in the changing roles of doctor and patient.
As the doctor-patient relationship became embedded in
complex systems of medical scientific management, the
creation of medical knowledge was dispersed between a
29 George Khushf, "A Framework for Understanding Medical Epistemologies," in Journal of Medicine and Philoso-
phy 38, no. 5 (Oxford: Oxford Univerrsity Press, 2013), 461-486.
30 Howell, Technology in the Hospital.
31 Martin Kaufman, Homeopathy in America: The Rise and Fall of a Medical Heresy (Baltimore: Johns Hopkins
Press, 1971), 166.
32 Frank W. Stahnisch and Marja Verhoef, "The Flexner Report of 1910 and its Impact on Complementary and Al-
ternative Medicine and Psychiatry in North America in the 20th
Century," in Evidence Based Complementary and Alter-
native Medicine (London: Hindawi, 2012).
33 Howell, Technology in the Hospital, 130.
profusion of actors. Radiologists, scientific researchers,
and hospital bureaucrats assumed positions in a self-
consciously scientific practice of medicine, thereby faci-
litating the standardization and stabilization of objective
medical knowledge.30
The rise of the modern hospital accompanied
reforms that advocated for increased professiona-
lism and scientism in medicine. In particular, the
Flexner Report of 1910 was greatly influential in es-
tablishing modern scientific medicine as the predomi-
nant paradigm for healthcare in America. Abraham
Flexner, who was trained in the natural sciences at
Johns Hopkins University, promoted a scientific pa-
radigm of academic education and research based on
the German university system. He sought to elimi-
nate “nonscientific” approaches to medicine, as he be-
lieved that “alternative medicine” competed with and
threatened appropriately scientific medical practices.
He recommended higher admission and graduation
standards for medical schools; standardization across
curricula, including basic science courses; and centra-
lization of medical institutions.The report had almost
immediate effects both for establishing mainstream
medical practice and for eliminating non-mainstream
practices. Between 1900 and 1922, 18 of the country’s
22 homeopathic colleges were closed, along with
colleges in electrotherapy.31
Some doctors who prac-
ticed homeopathy, osteopathy, eclectic medicine, and
physiomedicalism were jailed.32
In 1914, the board of managers of the Pennsyl-
vania Hospital, one of the first recognizably modern
American hospitals, made a decision to have all patients
x-rayed.33
The scientific authority of the x-ray justified the
professionalization and coordination of activity within the
American hospital at the same time that the demands of
professionalization and coordination standardized the use
of the x-ray.Radiology emerged as a specialty in medicine
in part because radiologists claimed that the x-ray, rather
than being the fairly simple and easy-to-operate machine
that could be used by amateur practitioners,was a complex
I
INFORMATION
AND AUTHORITY
(1918-1940)
24

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