Maternal mortality remains a cause of legitimate concern in developing parts of the world where rates often exceed 650 per 100,000 live births—at least twenty times higher than in the developed world, and appears impervious to all efforts to reduce it. Overwhelming poverty, insufficient health care, and the paucity of well-developed and thoroughly integrated programmes to reduce maternal mortality help ensure that these rates are comparable to, if not actually higher than, those found in some of the most unhealthy European cities and regions of the nineteenth century.

After the passing of the 1902 Midwives Act, a growing proportion of women were delivered by trained and supervised midwives. Standards of midwifery should therefore have improved over the first three decades of the twentieth century, yet nationally this was not reflected in the main outcome measures (stillbirths, early neonatal mortality and maternal death). This paper shows that there was a difference in the risks associated with delivery by the different attendants, with qualified midwives having the best outcome, then bona-fide (untrained) midwives and lastly doctors, even when account is taken of the fact that doctors were called in cases of medical need and may have been booked where a problematic delivery was expected. The paper argues that the lack of improvement in outcome measures could be consistent with improving standards of care among both trained and bona-fide midwives, because increased attention to the rules stipulating when midwives called for medical help meant that a doctor was called into an increasing number of deliveries (including less complicated ones), raising the chance of unnecessary and dangerous interventions.

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.

During the late nineteenth century, many British physicians rigorously experimented with hypnosis as a therapeutic practice. Despite mounting evidence attesting to its wide-ranging therapeutic uses publicised in the 1880s and 1890s, medical hypnosis remained highly controversial. After a decade and a half of extensive medical discussion and debate surrounding the adoption of hypnosis by mainstream medical professionals – including a thorough inquiry organised by the British Medical Association – it was decisively excluded from serious medical consideration by 1900. This essay examines the complex question of why hypnosis was excluded from professional medical practice by the end of the nineteenth century. Objections to its medical adoption rarelytook issue with its supposed effectiveness in producing genuine therapeutic and anaesthetic results. Instead, critics’ objections were centred upon a host of social and moral concerns regarding the patient’s state of suggestibility and weakened ‘will-power’ while under the physician’s hypnotic ‘spell’. The problematic question of precisely how far hypnotic ‘rapport’ and suggestibility might depart from the Victorian liberal ideal of rational individual autonomy lay at the heart of these concerns. As this essay demonstrates, the hypnotism debate was characterised by a tension between physicians’ attempts to balance their commitment to restore patients to health and pervasive middle-class concerns about the rapid and ongoing changes transforming British society at the turn of the century.

This article provides a new consideration of how Thomas Willis (1621–75) came to write the first works of ‘neurology’, which was in its time a novel use of cerebral and neural anatomy to defend philosophical claims about the mind. Willis’s neurology was shaped by the immediate political and religious contexts of the English Civil War and Restoration. Accordingly, the majority of this paper is devoted to uncovering the political necessities Willis faced during the Restoration of the English monarchy in 1660, with particular focus on the significance of Willis’s dedication of his neurology and natural philosophy to the Archbishop of Canterbury, Gilbert Sheldon. Because the Restoration of Charles II brought only a semblance of order and peace, Willis and his allies understood the need for a coherent defense of the authority of the English church and its liturgy. Of particular importance to Sheldon and Willis (and to others in Sheldon’s circle) were the specific ceremonies described in the Book of Common Prayer, a manual that directed the congregation to assume various postures during public worship. This article demonstrates that Willis’s neurology should be read as an intervention in these debates, that his neurology would have been read at the time as an attempt to ground orthodox worship in the structure of the brain and nerves. The political necessities that helped to shape Willis’s project also help us to better understand Willis’s innovative insistence that philosophical statements about the mind should be formulated only after a comprehensive anatomical investigation of the brain and nerves.