After losing the importance it had held around 1900 both as a colonial power and in the field of tropical medicine, Germany searched for a new place in international health care during decolonisation. Under the aegis of early government ‘development aid’, which started in 1956, medical academics from West German universities became involved in several Asian, African and South American countries. The example selected for closer study is the support for the national hygiene institute in Togo, a former German ‘model colony’ and now a stout ally of the West. Positioned between public health and scientific research, between ‘development aid’ and academia and between West German and West African interests, the project required multiple arrangements that are analysed for their impact on the co-operation between the two countries. In a country like Togo, where higher education had been neglected under colonial rule, having qualified national staff became the decisive factor for the project. While routine services soon worked well, research required more sustained ‘capacity building’ and did not lead to joint work on equal terms. In West Germany, the arrangement with the universities was a mutual benefit deal for government officials and medical academics. West German ‘development aid’ did not have to create permanent jobs at home for the consulting experts it needed; it improved its chances to find sufficiently qualified German staff to work abroad and it profited from the academic renown of its consultants. The medical scientists secured jobs and research opportunities for their postgraduates, received grants for foreign doctoral students, gained additional expertise and enjoyed international prestige. Independence from foreign politics was not an issue for most West German medical academics in the 1960s.

Medical historians have recently become interested in the veterinary past, investigating the development of animal health in countries such as France, the Netherlands, the United Kingdom and the United States. An appreciation of the German context, however, is still lacking – a gap in the knowledge that the present article seeks to fill. Providing a critical interpretation of the evolution of the veterinary profession, this investigation explains why veterinary and medical spheres intersected, drifted apart, then came back together; it also accounts for the stark differences in the position of veterinarians in Germany and Britain. Emphasis is placed on how diverse traditions, interests and conceptualisations of animal health shaped the German veterinary profession, conditioned its field of operation, influenced its choice of animals and diseases, and dictated the speed of reform. Due to a state-oriented model of professionalisation, veterinarians became more enthusiastic about public service than private practice, perceiving themselves to be alongside doctors and scientists in status, rather than next to animal healers or manual labourers. Building on their expertise in epizootics, veterinarians became involved in zoonoses, following outbreaks of trichinosis. They achieved a dominant position in meat hygiene by refashioning abattoirs into sites for the construction of veterinary knowledge. Later, bovine tuberculosis helped veterinarians cement this position, successfully showcasing their expertise and contribution to society by saving as much meat as possible from diseased livestock. Ultimately, this article shows how veterinarians were heavily ‘entangled’ with the fields of medicine, food, agriculture and the military.

In the wake of the Second World War there was a movement to counterbalance the apparently increasingly technical nature of medical education. These reforms sought a more holistic model of care and to put people – rather than diseases – back at the centre of medical practice and medical education. This article shows that students often drove the early stages of education reform. Their innovations focused on relationships between doctors and their communities, and often took the form of informal discussions about medical ethics and the social dimensions of primary care. Medical schools began to pursue ‘humanistic’ education more formally from the 1980s onwards, particularly within the context of general practice curricula and with a focus on individual doctor–patient relationships. Overall from the 1950s to the 1990s there was a broad shift in discussions of the human aspects of medical education: from interest in patient communities to individuals; from social concerns to personal characteristics; and from the relatively abstract to the measurable and instrumental. There was no clear shift from ‘less’ to ‘more’ humanistic education, but rather a shift in the perceived goals of integrating human aspects of medical education.The human aspects of medicine show the importance of student activism in driving forward community and ethical medicine, and provide an important backdrop to the rise of competencies within general undergraduate education.

The history of ‘electroshock therapy’ (now known as electroconvulsive therapy (ECT)) in Europe in the Third Reich is still a neglected chapter in medical history. Since Thomas Szasz’s ‘From the Slaughterhouse to the Madhouse’, prejudices have hindered a thorough historical analysis of the introduction and early application of electroshock therapy during the period of National Socialism and the Second World War. Contrary to the assumption of a ‘dialectics of healing and killing’, the introduction of electroshock therapy in the German Reich and occupied territories was neither especially swift nor radical. Electroshock therapy, much like the preceding ‘shock therapies’, insulin coma therapy and cardiazol convulsive therapy, contradicted the genetic dogma of schizophrenia, in which only one ‘treatment’ was permissible: primary prevention by sterilisation. However, industrial companies such as Siemens–Reiniger–Werke AG (SRW) embraced the new development in medical technology. Moreover, they knew how to use existing patents on the electrical anaesthesia used for slaughtering to maintain a leading position in the new electroshock therapy market. Only after the end of the official ‘euthanasia’ murder operation in August 1941, entitled T4, did the psychiatric elite begin to promote electroshock therapy as a modern ‘unspecific’ treatment in order to reframe psychiatry as an ‘honorable’ medical discipline. War-related shortages hindered even the then politically supported production of electroshock devices. Research into electroshock therapy remained minimal and was mainly concerned with internationally shared safety concerns regarding its clinical application. However, within the Third Reich, electroshock therapy was not only introduced in psychiatric hospitals, asylums, and in the Auschwitz concentration camp in order to get patients back to work, it was also modified for ‘euthanasia’ murder.

In the first decades of the twentieth century, a group of doctors under the banner of the social hygiene movement set out on what seemed an improbable mission: to convince American men that they did not need sex. This was in part a response to venereal disease. Persuading young men to adopt the standard of sexual discipline demanded of women was the key to preserving the health of the nation from the ravages of syphilis and gonorrhoea. But their campaign ran up against the doctrine of male sexual necessity, a doctrine well established in medical thought and an article of faith for many patients. Initially, social hygienists succeeded in rallying much of the medical community. But this success was followed by a series of setbacks. Significant dissent remained within the profession. Even more alarmingly, behavioural studies proved that many men simply were not listening. The attempt to repudiate the doctrine of male sexual necessity showed the ambition of Progressive-era doctors, but also their powerlessness in the face of entrenched beliefs about the linkage in men between sex, health and success.

How death should be measured was a subject of intense debate during the late 1960s, and one in which transplant surgeons had a particular interest. Legislation required a doctor to first pronounce ‘extinct’ the patients from whom ‘spare parts’ were sought for grafting. But transplant surgeons increasingly argued the moment of death was less important than was the moment of establishing that a patient was beyond the point of no return in dying, at which time she or he should be passed to the transplant team. This raised concerns that people identified as being a potential source of organs might not be adequately cared for in their own right. In 1968 the World Medical Association issued an international statement on death at its meeting in Sydney, Australia following a debate between delegates about how and by whom death should be assessed prior to organ removal. Soon afterwards Australian surgeons performed two of the one hundred and five heart transplants carried out around the world that year, dubbed by the New York Times to be one during which an ‘international epidemic’ of such grafts were carried out. This essay examines debates about death and transplanting, then analyses the pioneering Australian heart transplants, in the context of the Declaration of Sydney and continuing international discussions about whether these operations were moral and legal.