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Acknowledgements

This unit was written by Dr Alex Barber

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2.9.2 Searle's objection

In ‘What is a speech act?’, John Searle introduces a memorable example of an utterance in which Grice's conditions are all met for it to mean one thing, but where the words used suggest that the utterance means something quite different, if it means anything at all. The conclusion Searle invites us to draw is that what our utterances mean is not exhausted by the speaker's intentions alone. An additional consideration is the meaning of the expressions used. If they don't match the intentio
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2.3 Grice on natural and non-natural meaning

Ironically, the word ‘meaning’ has many different meanings. There are four occurrences of ‘mean’ (or ‘meaning’ or ‘meant’, etc.), italicised, in the following paragraph:

Roberto's instructor had been mean to put it so bluntly, but she was probably correct that his short legs meant he would never be a great dancer. He turned into the narrow alleyway, meaning to take a shortcut ho
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2.1 Introduction

The distinction noted in section 1 between the representational properties of a linguistic utterance (its ‘meaning’) and the representational properties of a mental state (its ‘content’) gives rise, naturally enough, to the suspicion that one of these might be more fundamental than the other. In this section I will look at a theory, most closely associated with the British philosopher H.P. Grice (1913–88), to the effect that the source of an utterance's meaning is the speaker's mind
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1.4 Three characteristic difficulties in discussions of representation

I have hinted that accounting for the nature of representation – whether it be the meaning of utterances or the content of our mental states – is not easy. There are several reasons for this, and it is as well to take note of some of them from the outset.

One is that there seem to be several different senses of ‘meaning’, ‘represents’ and related terms like ‘stands for’, ‘being about’, ‘expresses’ – differences that have been glossed over here but will need to
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1.1 Introduction

One of the most impressive but puzzling capacities we have is the ability to represent the world around us, both in talking about it among ourselves and in thinking about it as individuals. When someone utters the sentence, ‘The German economy is bouncing back’, for example, they are able to convey to their audience something about the German economy. Their utterance may be correct or it may be incorrect, but either way it is making a claim about how things are, and in this loose but intu
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4 Domestic care

Despite their best efforts, everyone fell ill at some point in their lives. Although historians of medicine write a great deal about how the sick were cared for by doctors and in hospitals, in the past (as nowadays) minor complaints were diagnosed and treated at home, almost entirely without the help of medical professionals, using special diets and home-made or bought-in remedies. As with preserving health, poor families had relatively few resources for treatment. They might seek advice from
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3.2 Health and wealth

While all classes regarded good health as desirable, access to various means of preserving or promoting it varied according to economic circumstances. For the upper and middle classes, with substantial amounts of disposable income, a wide range of options were available. They could access information about how to protect their health through books and articles in magazines. Many of these books were written (or at least claimed to be written) by doctors and other health-care professionals. An
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3.1 Introduction

Surrounded by the ever-present threat of ill health, not surprisingly, people expended a good deal of time and energy on trying to stay well. The late nineteenth century saw a new emphasis on promoting health, which was defined as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’ (quoted in Riley, 1997, p. 199). Health was not simply a desirable end in itself. The pursuit of health was portrayed as a moral duty: parents had a
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1 Access to healthcare, 1880–1930

The late nineteenth and early twentieth centuries have often been described as a period of progress, when the poorer classes gained access to a whole range of medical services previously reserved for the wealthy. In the past, this opening up of care was largely attributed to the state. Across Europe, central and local governments created health insurance schemes and new welfare services to provide the poor with access to care, from general practitioners (GPs) to outpatient and hospital care,
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Learning outcomes

After studying this unit, you should be able to do the following:

  • describe the wide range of methods of promoting health, preventing disease and providing care that were available to patients of different social groups and classes;

  • be aware of the inequalities of services – in terms of both quality of care and access to different services – open to different social groups and classes;

  • assess the significance of the roles of central and local gov
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Acknowledgements

This unit was written by Dr Debbie Brunton

The material acknowledged below is Proprietary (see terms and conditions) and is used under licence.

The extracts adapted for OpenLearn appear in full in Medicine Transformed: Health, Disease and Society in Europe 1800–1930 (ed Deborah Brunton), published by Ma
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References

Adair, R., Forsythe, B. and Melling, J. (1997) ‘Migration, family structure and pauper lunacy in Victorian England: admissions to the Devon County Pauper Lunatic Asylum, 1845–1900’, Continuity and Change, vol.12, no.3, pp.373–401.
Adair, R., Forsythe, B. and Melling, J. (1998) ‘A danger to the public? Disposing of pauper lunatics in late-Victorian and Edwardian England: Plympton St Mary Union and the
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4.5 Section summary

This section has given some of the sense of how historians work – by developing explanations of historical events, which are in turn challenged by new research that re-examines these ideas. In the case of the nineteenth-century asylum, much of the research carried out since the 1980s is based on new sources and detailed case studies which test old explanations for the timing and causes of the growth of asylums. In part, this reflects a trend in other areas of medical history and in the broa
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4.4 Outside the asylum walls: limits to the primacy of the asylum as a solution

Although historians have written about the asylum as the only response to insanity, there was in fact a widely used alternative. Boarding-out, or ‘family care’ of the insane, offered a genuine alternative to asylumdom. The exact form of boarding-out differed from one national and regional context to another, but basically it supported patients within domestic and often rural settings, generally with guardians or relatives in single dwellings and cottages. The practice had long been
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4.2 Social factors in the growth of the asylum: industrialisation, urbanisation and migration

Many historians link the rise of the asylum with the huge social changes of the nineteenth century. Some link the rise to industrialisation and urbanisation, pointing to the fact that asylums grew up in industrial regions and large cities. Frank Rice, for example, argues that in Scotland the great majority of asylums grew up if not within urban centres, then at least servicing urbanised communities, in the central belt of Scotland (Author(s): The Open University

4.1 Introduction

In the nineteenth century, the asylum became – as never before – the accepted place for the care and treatment of insanity. Until that time, people suffering from mental disorders were mostly cared for at home. Of the few institutions that offered care, most were rather small. They were funded by a combination of fees charged to patients and charitable donations or subscriptions. From the early nineteenth century, the number of asylums increased all over Europe as governments accepted a r
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3.4 War and women in medicine

Until 1914, the number of women attending medical schools grew slowly (Figure 4). In Britain, even after the 1876 Enabling Act allowed medical examining boards to grant licences to women, universities could still legally exclude women from their medical schools. By
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3.3 The reasons for – and emergence of – women working in medicine

Why in the face of such resistance did women wish to become doctors at all? Until recently, many authors have argued that women pursued a medical career as a form of service and for altruistic reasons. Women doctors claimed to be serving the public (one of the features of a profession) by preserving the modesty of women patients and ending their suffering at the hands of male doctors who did not understand the female body. This idea of women being called to serve for the betterment of others
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3.2 The push for – and opposition to – women in medicine

In Britain, the campaign for access to the medical profession began at Edinburgh University in 1869, and was led by Sophia Jex-Blake (1840–1913). Influenced by the feminist movement of the time, Jex-Blake had a wide-ranging education and was keen to earn an independent living. She fought a relentless battle with the Edinburgh University authorities. Initially, the university refused to admit a lone female student, so Jex-Blake recruited a small group of women. Once admitted, the women were
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