Cultures of neurasthenia: from Beard to the first world war

lead-paint in their products, though public health officials, notably in Boston and Baltimore, continued to identify cases in which lead-paint was implicated throughout the 1930s. The problem then largely disappeared from public view until the late 1940s and 1950s when hundreds of children started to appear in urban hospitals with acute plumbism. The trouble, it turned out, was lead-paint flaking off the walls and floors of former middle-class homes abandoned to slum landlords who allowed the houses to deteriorate while renting to poor families. It was the children of these families who were most severely affected by lead poisoning and, according to English, once again public health officials and the industry acted quickly to address the issue. They warned parents and physicians of the dangers of lead-paint. They began screening and abatement programmes. They also negotiated a voluntary standard that substantially lessened the use of lead in paints intended for indoor use. The result of these initiatives was a general reduction of lead in the environment; a reduction also promoted by preventive and environment regulations, and federal legislation to encourage screening. Acute childhood lead poisoning largely disappeared as a public health problem, and the definition of childhood plumbism also changed to focus more on sub-clinical lead poisoning. English concludes that the reduction of lead in children's surroundings can be seen as "a public health triumph" (p. 185). But, English's "triumph" was surely as much about profit as it was about public health. It is true that the lead-paint industry was often a leader in lead poisoning research, but its motives were not without self-interest. Research on lead hazards provided the industry with ammunition with which to discredit critics who suggested that the real scope of the problem was bigger than the industry claimed. It also provided the industry with a scientific rationale for continuing to advertise lead as safe despite substantial evidence to the contrary. English tends to downplay such contrary evidence by emphasizing uncertainties about the dangers of lead, and the "conscientious" efforts by the industry to improve knowledge of its hazards. He is less willing to explore how industry-sponsored research might promote uncertainty and ignorance, and he may also be too generous towards public health officials who for years blamed the poor for their children's ills, and sought instead to promote basic biomedical research into the action of lead on the body. Eventually, government funding moved the locus …