In recent years, there has been an abundance of literature written on the subject of people with disabilities. However, there has been a noticeable paucity of information available on the historical aspects of disabled persons. This book will help to develop a social history on disabilities by providing a multidisciplinary overview of images of people with disabilities in Western history; promoting the exchange of cross-disciplinary information on disabled people from art, literature, original data, and historical works; filling the gap in our understanding of how disabled people were viewed prior to modern history; illustrating how art and literature can be used to understand how disabled people were perceived in their respective times; and showing how historical factors shape some of our current perceptions about disability. With the growing interest in people with disabilities and the recent passage of the American Disability Act, this book will be of great importance to special educators, historians, students of the humanities, and social scientists.
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"Gimp!" "Cripple!" The critical epithet often betokens the scorn and fear that disability provokes in the onlooker. Indeed, the human perception of illness is based as much on the dreaded functional consequences of the sequelae of disease as on mortality. An investigation of the historical change of such perceptions thus is fundamental to our understanding of medicine and disease in society.
Dr. Covey, a member of the Colorado Department of Human Services and of the College of Continuing Education at the University of Colorado in Boulder, has amassed a great deal of information in this book regarding the history of disabled persons to help put their conditions in historical context. Having previously written about Western images of the elderly, he also includes many illustrations from art through the centuries. He examines sequentially the perceptions of those with physical, infectious, mental, visual, aural, and developmental disabilities. The work provides a concatenation of people and places associated with disability and appropriately considers the causes broadly (including tuberculosis, syphilis, and other infections). Dr. Covey does a worthy job of uncovering secondary sources relating to the history of disability, and his bibliography is an excellent starting point for anyone interested in the field.
Given the promise of the title, however, this work has many shortcomings. In general, Social Perceptions does not describe the "why" behind a stereotype but merely points out the existence of that perception. For example, Covey evocatively raises the image of Victor Hugo's famed Hunchback of Notre Dame without investigating the specific context of Hugo's fascination with the real-life porter, Corcorito, he used as a model. Much can be discovered about the convergence of late Romanticism, curiositas naturae, and a sense of the "other" from such details. Some of his examples are breathtaking in the potential they hold for unpacking the social meaning of disabilities. For example, the image of the great Impressionist Auguste Renoir with paintbrushes tied to his forearms because of his disabling arthritis invites volumes of investigation into the impact of the disability on Renoir's art and that of his art on the wider world, as well as into the way others understood the impact of his disability on his art. This is the stuff of a "handicap."
Here, too, is another shortcoming. During training, physiatrists and therapists are taught to differentiate strictly among "impairment," "disability," and "handicap." I would argue that Dr. Covey has blended the latter two terms. The premise of the book, that "it is commonly understood that the meanings attached to disability differ among cultures and within cultures, and over time," despite Covey's acknowledgment that "a handicap is not determined by an individual's physical limitations, but instead reflects the social consequences of that disability," belies his use of the word "disability" throughout the rest of the book. This book should really be called Social Perceptions of People with Handicaps in History.
Furthermore, despite the amount of material presented, glaring omissions from this "overview of major historical contexts" include discussions of the social drive of eugenics at the turn of the 20th century and its implications for the policies of the Nazis during World War II and of the role of philanthropy and governmental "big science" in the American struggle with polio. But the greater shortcoming is still the brevity of analysis with which the author treats each subject. For example, the sociocultural nexus of tuberculosis ("consumption") and Romanticism in the 19th century deserves far more than a paragraph in a book on the social perceptions of illness.
Finally, given his reliance on secondary sources, Dr. Covey would have better served his readers by citing more nuanced studies. For example, in discussing the perception of the disabled as beggars, he does not include the abundant and insightful literature on poverty and illness. His section on syphilis misses the work of Allan Brandt, and those on the premodern periods omit a number of standard references. Furthermore, his bibliography is confined to sources written in English, though the preponderance of his subject matter is European.
In his conclusion, Dr. Covey refers to the untold stories of the masses of disabled people who were not destined to be Beethovens or Roosevelts. This point is the substance of social history and needs to be voiced more loudly. Nevertheless, Dr. Covey has assembled a great deal of useful information, which will aid him and others in continuing the critical research into the history of the disabled and handicapped.
Reviewed by Walt Schalick, III, M.D., Ph.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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