Shadows in the Valley
A Cultural History of Illness, Death, and Loss in New England, 1840-1916
Explores the impact of changing medical practices on ordinary people in nineteenth-century America
How does the experience of sickness, death, and loss change over time? We know that the incidence and virulence of particular diseases have varied from one period to another, as has their medical treatment. But what was it like for the individuals who suffered and died from those illnesses, for the health practitioners and institutions that attended to them, and for the families who buried and mourned them?
In Shadows in the Valley, Alan Swedlund addresses these questions by closely examining the history of mortality in several small communities in western Massachusetts from the mid-nineteenth to the early twentieth century—from just before the acceptance of the germ theory of disease through the early days of public health reform in the United States. This was a time when most Americans lived in rural areas or small towns rather than large cities. It was also a time when a wide range of healing practices was available to the American public, and when the modern form of Western medicine was striving for dominance and authority. As Swedlund shows, this juncture of competing practices and ideologies provides a rich opportunity for exploring the rise of modern medicine and its impact on the everyday lives of ordinary Americans.
To indicate how individuals in different stages of their lives were exposed to varying assaults on their health, the book is structured in a way that superimposes what the author calls “life-course time” onto chronological time. Thus the early chapters look at issues of infancy and childhood in the 1840s and 1850s and the last chapters at the problems of old age after 1900. The reader becomes familiar with specific individuals and families as they cope with the recurrent loss of children, struggle to understand the causes of new contagions, and seek to find meaning in untimely death. By using a broad time frame and a narrow geographical lens, Swedlund is able to engage with both the particularities and generalities of evolving medical knowledge and changing practice, and to highlight the differences in personal as well as collective responses to illness and loss.
"This richly textured study employs dozens of powerful case studies—as well as mortality statistics and mourning rituals, medical treatments and emerging public health practices—to illuminate 'how death informed life' for a range of New Englanders, including infants and the elderly, the Yankee elite and Irish immigrants, women in childbirth and men at war, over the long nineteenth century. Through his careful attention to both patients and pathogens as key characters in this story, anthropologist Alan Swedlund offers a creative model for a complex and humane history of medicine."—Karen Halttunen, University of Southern California
"Swedlund combines anthropological and historical approaches to describe medical practices, mourning rituals, and the emotions and meanings attached to the experience of illness and death in this fascinating account of illness, death, and mourning in a small New England town from the mid-19th to the early-20th century. . . . The author artfully manages the complex data, and his book, organized along major stages of the life course, gives insights into the connections between health, disease, medicine, culture, and social processes beyond the period described. Summing Up: Highly recommended."—Choice
"Sets a new standard for the growing body of literature on the ways disease has shaped the contours of our world. Seamlessly blending history and medical anthropology, Swedlund tells the riveting tale of sickness in an earlier time as a distinctly human process, filled to the brim with meanings and emotions, actions and uncertainties. . . . A must read for medical anthropologists, health historians, and all those with an abiding concern with comprehending the human condition."—Merrill Singer, University of Connecticut
"By his intense studies of 'smaller communities at the margins of the mainstream' (Swedlund) illuminates how ordinary people dealt with major issues of life and death. . . . A rewarding read."—Yale Journal of Humanities in Medicine
"A handful of black-and-white photographs illustrate this scholarly, exhaustively researched and aptly presented account. A welcome contribution to American history and sociology shelves."—Midwest Book Review
"Shadows in the Valley does an excellent job of describing the context of death and disease. . . . It deserves a wide readership among scholars of demographic history and nineteenth century New England."—EH.NET
"True to his training, Swedlund is careful to lay out his research methodology. As he move on to blend together his stories of medical knowledge, personal tragedy and community dynamics, however, the book becomes increasingly absorbing and increasingly human."—Life and Times
"Quite simply a remarkable work. . . . In this meticulously researched, gracefully written, and poignantly illustrated work, Swedlund weaves the strands of life and death in small communities into the larger fabric of cultural and medical history."—Historical Journal of Massachusetts