

@mastersthesis {6302,
	title = {The discourse of public health in {Lyon}, 1848-1914},
	year = {1997},
	note = {9808683},
	school = {University of Maryland College Park},
	type = {phdPh.{D}.},
	address = {Ann Arbor},
	abstract = {This study challenges the thesis of medicalization as a valid framework within which to examine the evolution of public health policy in France. The thesis of medicalization describes public health reform as a movement from above in which enlightened urban elites and physicians united to impose hygienic norms on the ignorant masses. However, I argue that doctors and municipal administrators did not always share a unity of purpose, that much of the impetus for public health reform originated within the popular element, and that public health policy expressed the convergence of popular and elite ideals. While all agreed on the need for reform, public health policy sometimes shortcircuited because it involved conflicting definitions of the proper role of the state and the limits of individual liberty. These conflicts translated into public health law and created incoherence and ambiguity in national and municipal legislation. Problems of finance and adequate manpower also impacted on the progress of public health reform. Their reluctance to make massive investments in sanitation projects caused Second Empire administrators to privatize Lyon{\textquoteright}s water system. Under the Third Republic, monetary caution similarly induced municipal councilors to procrastinate before repurchasing the water concession from the exploitative grasp of private monopoly. The limitations of municipal resources caused Lyon{\textquoteright}s schools to become congested breeding grounds for disease, and the shortage of responsible personnel produced inefficiencies and irregularities in the inspection of schools, factories and prostitution. Medical attitudes resulted in other hitches in public health policy, since doctors failed to perceive the wellspring of popular interest in hygiene and myopically ignored the harsh conditions of working class life that underlay popular deviation from hygienic norms. Though the thesis of medicalization stresses the hegemony of doctors over health policy, the administration discerned the narrowness of the doctors{\textquoteright} vision and sometimes sided with the people against the medical inspectors. The administration understood that the doctors{\textquoteright} rigid aloofness and lack of real commitment to their duties alienated many humble citizens. Having no real understanding of the people, doctors brought a limited and subjective viewpoint to their analysis of health among workers. Social, moral and economic concerns often overwhelmed scientific objectivity. Doctors{\textquoteright} discussions of schools became a diatribe on working class degeneration. Their discussion of water pontificated on the failure of working class people to assimilate hygienic norms instead of acknowledging popular clamour for clean filtered water. Concern with French economic stagnation dominated medical attitudes toward industry and made doctors underplay the harmful effects of industrial pollution on the health of workers and the quality of the urban environment. Medical analysis of prostitution and syphilis was a dogmatic sermon on morality and discipline rather than a scientific study of disease prevention. Doctors tried to veil their subjective attitudes in the respectable cloak of statistics. However, they presented statistics in biased and expedient ways that betrayed their social prejudices and their intention to improve their weak public image.},
	keywords = {0335:European history, 0573:Public health, 0585:Science history, European history, France, Health and environmental sciences, Public health, Science history, Social sciences},
	url = {http://search.proquest.com/docview/304356948?accountid=14270},
	author = {Yarkony, Lisa}
}
