• This paper was written while the author was a consultant in residence at the Netherlands Institute for Preventive Medicine, Leiden. For their general encouragement and the opportunity to pursue this topic I will always be grateful.

  • It was presented at the Medical Sociology Conference of the British Sociological Association at Weston-Super-Mare in November 1971. My special thanks for their extensive editorial and substantive comments go to Egon Bittner, Mara Sanadi, Alwyn Smith, and Bruce Wheaton.


  • 1

    T. Szasz: The Myth of Mental Illness, Harper and Row, New York, 1961; and R.Leifer: In the Name of Mental Health, Science House, New York, 1969.

  • 2

    E.g. A. Toffler: Future Shock, Random House, New York, 1970; and P. E.Slater: The Pursuit of Loneliness, Beacon Press, Boston, 1970.

  • 3

    Such as B. Wootton: Social Science and Social Pathology, Allen and Unwin, London, 1959.

  • 4

    H. Sigerist: Civilization and Disease, Cornell University Press, New York, 1943.

  • 5

    M. Foucault: Madness and Civilization, Pantheon, New York, 1965; and Szasz: op. cit..

  • 6

    G. Rosen: A History of Public Health, MD Publications, New York, 1955; and G. Rosen: “The Evolution of Social Medicine”, in H. E.Freeman, S.Levine and L. G.Reeder, (eds.): Handbook of Medical Sociology, Prentice-Hall, Englewood Cliffs, N.J., 1963, pp. 1761.

  • 7

    Wootton: op. cit., p. 206.

  • 8

    Two excellent discussions are found in V. Aubert and S. Messinger: ‘The Criminal and the Sick’, Inquiry, Vol. 1, 1958, pp. 137160; and E. Freidson: Profession of Medicine, Dodd-Mead, New York, 1970, pp. 205–277.

  • 9

    Freidson: op. cit., p. 251.

  • 10

    J. C. Norman: ‘Medicine in the Ghetto’, New Engl. J. Med., Vol. 281, 1969, p. 1271.

  • 11

    “To Save the Heart; Diet by Decree?” Time Magazine, 10th January, 1968, p. 42.

  • 12

    J. L. Goddard quoted in the Boston Globe August 7th, 1966.

  • 13

    K. Dunnell and A. Cartwright: Medicine Takers, Prescribers and Hoarders, in press.

  • 14

    E.g. S. Alinsky: “The Poor and the Powerful”, in Poverty and Mental Health, Psychiat. Res. Rep. No. 21 of the Amer. Psychiat. Ass., January 1967; and B. Wedge: ‘Psychiatry and International Affairs’, Science, Vol. 157, 1961, pp. 281285.

  • 15

    H. L'Etang: The Pathology of Leadership, Hawthorne Books, New York, 1970.

  • 16

    Szasz: op. cit.; and Leifer: op. cit..

  • 17

    Freidson: op. cit.; and T. Scheff: ‘Preferred Errors in Diagnoses’, Medical Care, Vol. 2, 1964, pp. 166172.

  • 18

    R. Dubos: The Mirage of Health, Doubleday, Garden City, N.Y., 1959; and R. Dubos: Man Adapting, Yale University Press, 1965.

  • 19

    E.g. the general summaries of J. W. Meigs: ‘Occupational Medicine’, New Engl. J. Med., Vol. 264, 1961, pp. 861867; and G. S. Siegel: Periodic Health Examinations—Abstracts from the Literature, Publ. Hlth. Serv. Publ. No. 1010, U.S. Government Printing Office, Washington D.C., 1963.

  • 20

    I. H. Pearse and L. H. Crocker: Biologists in Search of Material, Faber and Faber, London, 1938; and I. H. Pearse and L. H. Crocker: The Peckham Experiment, Allen and Unwin, London, 1949.

  • 21

    Dunnell and Cartwright: op. cit.; and K. White, A. Andjelkovic, R. J. C. Pearson, J. H. Mabry, A. Ross and O. K. Sagan: ‘International Comparisons of Medical Care Utilization’, New Engl. J. of Med., Vol. 277, 1967, pp. 516522.

  • 22

    Freidson: op. cit..

  • 23

    Drug Efficiency Study–Final Report to the Commissioner of Food and Drugs, Food and Drug Adm. Med. Nat. Res. Council, Nat. Acad. Sci., Washington D.C., 1969.

  • 24

    Reported in L. Eisenberg: ‘Genetics and the Survival of the Unfit’, Harper's Magazine, Vol. 232, 1966, p. 57.

  • 25

    This general case is argued more specifically in I. K. Zola: Medicine, Morality, and Social Problems–Some Implications of the Label Mental Illness, Paper presented at the Amer. Ortho-Psychiat. Ass., March 2023, 1968.

  • 26

    D. H. Russell: ‘The Sex Conversion Controversy’, New Engl. J. Med., Vol. 279, 1968, p. 536.

  • 27

    F. Crick reported in Time Magazine, April 19th, 1971.

  • 28

    H. Arendt: Eichmann in Jerusalem A Report on the Banality of Evil, Viking Press, New York, 1963.

  • 29

    G. S. Myers quoted in L.Lasagna: Life, Death and the Doctor, Alfred Knouf, New York, 1968, pp. 215216.

  • 30

    Freidson: op. cit., p. 354.