From gluttony to obesity: moral discourses on apoplexy and stroke

Current UK medical guidance on the management of stroke includes advice on reducing behavioural factors that place people at risk of the disease. This paper explores the historical background to the construction of this risk; it starts by investigating the connections made between individual behaviours and the causation of apoplexy in the medical discourse during the 18(th) and 19(th) centuries described in English medical textbooks from the 1700s. In outlining the emergence of a biomedical discourse around apoplexy and stroke, we note how a number of judgemental and moral concerns are articulated particularly around diet and exercise. While different in emphasis and starting point these discourses have their echo in contemporary approaches to the prevention of stroke. We seek to show that many of the themes common in current health promotion and public health strategies can be seen as continuities of earlier concerns regarding people's health; albeit now operating against the backdrop of a somatic society rather than a broader sense of moral regulation. We also hope to show how the understanding and prevention of stroke feeds into the moral discourse of the 'obesity crisis' confronting the affluent nations of North America and Europe.