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This chapter introduces the type 2 diabetes epidemics of Japan and the United States, noting national differences in response to the epidemics among medical, public health, and patient communities. It summarizes the tradition of approaching medicine as a social enterprise in the social sciences, describes the organization of the book, and motivates its central theoretical and empirical questions.

This chapter presents a discussion of the book’s theoretical framework and central argument, arguing that the everyday practice of biomedicine and the social process of biomedicalization rest on the foundations of relatively widely shared narratives within communities. As these narratives and narrative fragments are accessed selectively and deployed with creativity and contradiction, the transformations social scientists call biomedicalization are necessarily inflected and informed by their sociocultural context through what is available from the cultural repertoire or “tool kit” and how those cultural materials are deployed. As a result, biomedicalization does not eradicate diversity in “things medical,” but rather produces it. The following chapters explore this argument empirically, organized in descending order of imagined social space: world, nation, exam room, and home. Each is a site at which the meaning of the diabetes epidemic is imagined, negotiated, contested, and reimagined.

This chapter explores the claim that psychiatry has failed to make progress and gotten on the wrong track by expanding the diagnostic system to include conditions that are not really disorders. In other words, some believe that much of the imperfect community is a classificatory mistake as a result of over medicalization. Progress, it is said, would result in classifying only real disorders. A more pragmatic, less metaphysically encumbered notion of progress is offered. The history of what many consider to be the ultimate mythical psychiatric disorder – hysteria – is reviewed. Hysteria is analyzed in nominalist fashion examining its conceptual contrasts, seeing how it has been decomposed into components, and reviewing its stratification in the DSM. The chapter concludes by emphasizing the importance of metaphysical concepts such as real and objective for thinking philosophically about psychiatric disorders, urging also, that we think philosophically about these metaphysical concepts themselves.

Depending on which gene a child has, being sent to daycare can either increase or decrease a child’s chances of developing allergies. Likewise, children with one form of a gene respond better to an empathy-oriented approach to discipline, while children with the other form of the gene respond better to a punishment-oriented approach to discipline. Research on these cases of gene-environment interaction raises the prospect of a “genetic guide to parenting”—the idea being that information about the child’s genome would inform parental decisions about everything from whether or not to send a child to daycare, to how to respond to the next temper tantrum. As calls for the whole genome sequencing of newborns increase and the goal of a $1000 genome grow near, the reality of a genetic guide to parenting becomes more likely. This chapter considers what a genetic guide to parenting might look like, evaluating the promises and perils of this new technology as they relate to concerns about medicalization and genetic determinism.

This chapter provides an ethnographic case study of divided medicalization—the process through which multivalent, identitarian conditions get produced and then reduced to fit within a preexisting, disease-oriented clinical paradigm. The chapter is a clinical ethnography of a clinic located within a university medical center in an East Coast city, serving children diagnosed with Asperger’s syndrome. As medical categorizations and classifications expanded beyond the borders of the body to examine and remedy disorders of social life in the world, the staff shifted their own practice, exploring interventions that were playful and social, determined by pleasures as well as pathologies, and driven by the goal of expanding relationships rather than containing contagion. These interventions, however, crossed and complicated the clinic's carefully maintained boundaries between the inside and the outside of both the building and the body. In the end, the elements of autism that least fit within the existing medical paradigm were not incorporated into that paradigm but instead came to be extruded from it. Interpersonal, aesthetic, and identitarian elements of the condition were at first invited into but then gradually banished from the clinic, leaving behind an incomplete representation of complex social phenomena as diseases to be eliminated from individuals.

This chapter investigates how discourses on disability may assist the reconsideration of Deleuze’s understanding of sexual pleasure. Deleuze critiques the hierarchal organisation of bodies and their facialisation through social, political and gendered functions, and yet, a closer look at the rerouting of sexual pleasures of anomalous bodies suggests that his rejection of the orgasm rests also on ableist assumptions about how bodies work. Employing Deleuzian concepts such as becoming and faciality, this chapter analyses the ‘disabling’ of sexuality, that is, the way that sexual pleasure is hijacked by cultural, political, commercial and medical discourses. At the same time, reading Deleuze through discourses on disability makes it possible to ask if bodies that, in different ways, fail to function according to predetermined standards can express more productive relations between the orgasm and the body than the one Deleuze envisions.

Opening with a description of the wounds soldiers received in the First World War, the introduction offers readers an overview of the significance of medicine to modern warfare. A brief review of the new military weapons and tactics deployed between 1914 and 1918 outlines how and why these developments resulted in unprecedented casualties and why the German Army was so unprepared for them. Next the introduction reviews the historiography of medicine in the First World War, while also pointing to the paucity of studies which examine this phenomenon in Germany. After elaborating upon why an academic study of the role of medicine in WWI Germany remains to be written and why historians of both war and medicine should be interested in such a study, the introduction then outlines how this book addresses this scholarly lacuna while also contributing to larger debates among historians of medicine. Lastly this section introduces and defines key concepts to the study, including terms such as militarization, medicalization, and specialization.

The conclusion outlines how the medical and social developments driven by the war had important long-term consequences for various segments of German society: orthopaedists, university medical departments, disabled veterans, and disabled soldiers. It demonstrates how the specialization of orthopaedics in Germany differed in important ways from its specialization in other Western nations and points out how and why this was fundamentally tied to their war-time service.The conclusion also examines the consequences of war-time developments in orthopaedics for disabled civilians in Germany after the war. Finally, the conclusion makes broader historiographical points for historians of war and historians of medicine, and demonstrates how important developments in medicine, medical science, and medical technology were for the “management of modern warfare” in the German Empire from 1914 through 1918.

This chapter explores the development of the legal concepts of idiocy and imbecility over the eighteenth and nineteenth centuries, examining legal theory as well as evidence from civil court cases to reveal an ongoing conflict between libertarian resistance to state intervention in the lives of citizens, however mentally incapacitated they might be, and a belief that the state should be responsible for protecting individuals against exploitation and the corruption of bloodlines. From the late eighteenth century, French medico-legal theorists, supported by the ‘scientific’ enlightenment ideals of the French revolution, proposed a medicalised appropriation of legal decision-making over capacity. While these ideas gained some currency among a small group of British medical men working in the field of idiocy, they faced strong public and legal resistance throughout the nineteenth century on the grounds of liberty of the subject. Both legal and medical formulations of idiocy in the eighteenth and nineteenth centuries borrowed heavily from popular, ‘common-sense’ public notions about what constituted an idiot.

Chapter six traces the reform efforts of the fourteenth and fifteenth centuries, which eventually led to the consolidation of small independent hospitals into large civic institutions that became increasingly medicalized. Health boards created after the Black Death led to secularization of health care and poor relief. These social service institutions evolved over the early decades of the century and were a gradual response to the evolving needs and challenges of the population and the end of the communal era. This unification and institutionalization of civic oriented hospital care, resulted in one large Ospedale Maggiore, which was duplicated in towns and cities throughout Italy in the mid fifteenth century. It signified the end of the small, independent hospital movement that had so transformed the landscape of urban society earlier in the Middle Ages. The process of centralization that swept hospitals up in its wake was a universal feature of Italian state-formation in the age of the Renaissance

This chapter introduces the volume by situating historical epistemology in its proper intellectual and cultural genealogy (from the late nineteenth century to the present), by arguing for the usefulness of historical epistemology to move beyond the limitation of the medicalization thesis, and by providing an overview of the book and delineating a history of the objects, authority, and existence of modern Chinese medicine that connects the broader social forces and challenges of globalization to the internal epistemic formations of East Asian medical knowledge.

Nostalgia became a thing in the Age of Enlightenment, in the writings and actions of physicians and philosophes who heard about this mysterious Swiss illness. Across Europe and the North Atlantic, medical faculties debated the merits of medicalizing homesickness, outlining two competing explanations for the disease: a materialistic and deterministic one focused on environmental (atmospheric) constraints and organic transformations; and a psychological one that instead insisted on the emotional consequences of displacement and social disruption. By the end of the eighteenth century, others including the likes of Rousseau and Kant began talking of nostalgia in more benign terms as well, outlining aesthetic concerns and forms of interiority typical of a nascent romantic sensibility. But it was in the rather more prosaic medical practice and professional logics of military medicine that nostalgia truly came into its own, as French army surgeons in particular embraced the diagnosis in their battle to save soldiers’ lives and assert their own professional status.

Counter to many expectations that we would adopt a 24 hour society, I discuss herein the ways that the American work day has remained steadfastly diurnal and the various global and local coordinations that have occurred to allow this – including workplace napping.

This chapter focuses on contemporary politics around time and its use in American society; I focus primarily on the Take Back Your Time movement and the rearrangement of school start times to allow students to get more sleep throughout the school week.

This chapter traces the history of the use of the sleepwalking defense in the U.S. and its roots in conceptions of desire and nature. I follow this discussion by focusing on the invention of drowsy driving laws at the turn of the 21st century, laws that explicitly recognize the effects associated with ongoing sleep deprivation.

This chapter takes the concerns of how sleep makes us human into stranger realms – extreme sports, military research, and adventurous science. At once, the very basis of sleep is being tested in these situations, while sleep’s potentialities are being isolated.

What compels us to want to not sleep? I introduce cases of perpetual sleeplessness to challenge this imagined posthuman future of sleep, attempts to break records to stay awake, science fictional representations of experiments to eradicate sleep, and scientific attempts to reduce or dramatically alter our sleep.

Dominant conceptions of sleep have changed over time, and so have American understandings of the normal, the ideal, the disorderly, and pathological. These changes are the result of scientific, medical, and popular forces: the identification of circadian rhythms that govern feelings of alertness and sleepiness, the nosological definition of various pathological forms of sleep, and commercial and media representations of sleep have all collaborated in altering how sleep is conceived. These are all changes that have occurred since the 1880s and been dependent upon social formations and cultural expectations from early colonial America through the Industrial Revolution. How Americans sleep now is tied to these historical forces and human physiology.