Histories of the global smallpox eradication programme have tended to concentrate on the larger national formations in Africa and Asia. This focus is generally justified by chroniclers by the fact that these locations contributed a major share of the world’s annual tally of variola, which meant that international agencies paid a lot of attention to working with officials in national and local government on anti-smallpox campaigns in these territories. Such historiographical trends have led to the marginalisation of the histories of smallpox eradication programmes in smaller nations, which are presented either in heroic, institutional tropes as peripheral or as being largely shorn of sustained campaigns against the disease. Using a case study of Bhutan, a small Himalayan kingdom sandwiched between India and China, an effort is made to reclaim the historical experiences in small national entities in the worldwide smallpox eradication programme. Bhutan’s experience in the 1960s and 1970s allows much more in addition. It provides us with a better understanding of the limited powers of international agencies in areas considered politically sensitive by the governments of powerful nations such as India. The resulting methodological suggestions are of wider historical and historiographical relevance.

This article explores the ways in which risk and responsibility were conceptualised in the late nineteenth and early twentieth centuries by surgeons, their patients and the lay public. By this point surgery could be seen, simultaneously, as safe (due to developments in surgical science) and increasingly risky (because such progress allowed for greater experimentation). With the glorification of the heroic surgeon in the late Victorian and early Edwardian period came a corresponding, if grudging, recognition that successful surgery was supported by a team of ancillary professionals. In theory, therefore, blame for mistakes could be shared amongst the team; in practice, this was not always the case. Opening with an examination of the May Thorne negligence case of 1904, I will also, in the latter third of this piece, focus on surgical risks encountered by women surgeons, themselves still relatively new and, therefore, potentially risky individuals. A brief case study of the ways in which one female-run institution, the New Hospital for Women, dealt with debates surrounding risk and responsibility concludes this article. The origin of the risks perceived and the ways in which responsibility was taken (or not) for risky procedures will provide ways of conceptualising what ‘surgical anxiety’ meant in the 1890s and 1900s.

Social historians have argued that the reason the 1918–19 ‘Spanish’ influenza left so few traces in public memory is that it was ‘overshadowed’ by the First World War, hence its historiographical characterisation as the ‘forgotten’ pandemic. This paper argues that such an approach tends to overlook the crucial role played by wartime propaganda. Instead, I put emotion words, emotives and metaphors at the heart of my analysis in an attempt to understand the interplay between propaganda and biopolitical discourses that aimed to regulate civilian responses to the pandemic. Drawing on the letters of Wilfred Owen, the diaries of the cultural historian Caroline Playne and the reporting in the Northcliffe press, I argue that the stoicism exhibited by Owen and amplified in the columns of The Times and the Daily Mail is best viewed as a performance, an emotional style that reflected the politicisation of ‘dread’ in war as an emotion with the potential to undermine civilian morale. This was especially the case during the final year of the conflict when war-weariness set in, leading to the stricter policing of negative emotions. As a protean disease that could present as alternately benign and plague-like, the Spanish flu both drew on these discourses and subverted them, disrupting medical efforts to use the dread of foreign pathogens as an instrument of biopower. The result was that, as dread increasingly became attached to influenza, it destabilised medical attempts to regulate the civilian response to the pandemic, undermining Owen’s and the Northcliffe press’s emotives of stoicism.

This article presents a plethora of fragments from the medical notebooks found in the Cairo Genizah that comprise a unique source of historical data for scholarly study and for a better understanding of the ways in which medieval medical knowledge in Egypt was transferred from theory to practice and vice versa. These documents provide the most direct evidence we have for preferred practical medical recipes because they record the choices of medical practitioners in medieval Cairo. Since the language most commonly used in them was Judaeo-Arabic, they were evidently written by Jews. The medical genre in the notebooks was primarily pharmacopoeic, consisting of apparently original recipes for the treatment of various diseases. There are also a few notebooks on materia medica. The subject matter of the Genizah medical notebooks shows that they were mostly of an eclectic nature, i.e. the writers had probably learnt about these treatments and recipes from their teachers, applied them at the hospitals where they worked or copied them from the books they read. Foremost among the subjects dealt with were eye diseases, followed by skin diseases, coughs and colds, dentistry and oral hygiene, and gynaecological conditions. The writers of the Genizah notebooks apparently recorded the practical medical knowledge they wished to preserve for their future use as amateur physicians, students, traditional healers or professional practitioners.

Historical accounts of colonial science and medicine have failed to engage with the Colonial Office’s shift in focus towards the support of research after 1940. A large new fund was created in 1940 to expand activities in the colonies described as fundamental research. With this new funding came a qualitative shift in the type of personnel and activity sought for colonial development and, as a result, a diverse group of medical and technical officers existed in Britain’s colonies by the 1950s. The fact that such variety existed amongst British officers in terms of their qualifications, institutional locations and also their relationships with colonial and metropolitan governments makes the use of the term ‘expert’ in much existing historical scholarship on scientific and medical aspects of empire problematic. This article will consider how the Colonial Office achieved this expansion of research activities and personnel after 1940. Specifically, it will focus on the reasons officials sought to engage individuals drawn from the British research councils to administer this work and the consequences of their involvement for the new apparatus established for colonial research after 1940. An understanding of the implications of the application of the research council system to the Colonial Empire requires engagement with the ideology promoted by the Agricultural Research Council (ARC) and Medical Research Council (MRC) which placed emphasis on the distinct and higher status of fundamental research and which privileged freedom for researchers.

This article examines the reception of the early modern hospital among the indigenous people of the Andes under Spanish colonial rule. During the period covered by this study (sixteenth to mid-eighteenth centuries), the hospital was conceived primarily as a manifestation of the sovereign’s paternalistic concern for his subjects’ spiritual well being. Hospitals in the Spanish American colonies were organised along racial lines, and those catering to Indians were meant to complement the missionary endeavour. Besides establishing hospitals in the main urban centres, Spanish colonial legislation instituted hospitals for Indians in provincial towns and in small rural jurisdictions throughout the Peruvian viceroyalty. Indian hospitals often met with the suspicion and even hostility of their supposed beneficiaries, especially indigenous rulers. By conceptualising the Indian hospital as a tool of colonial government, this article investigates the reasons behind its negative reception, the work of adaptation that allowed a few of them to thrive, and the eventual failure of most of these institutions.

This article continues the analyses in Medical History 52 (2008), 73–90, 365–86 of William Harvey’s self-understanding as the philosopher and discoverer of the blood’s circulation. Harvey brilliantly and subversively assumed the persona of the mythological Hercules to embody his own anatomical labour in De motu cordis et sanguinis (1628). He reprised the role in self-defence against accusations in the College of Physicians, London, of his breach of faith with medical tradition. Harvey sought to usurp the medical epithet ‘a second Hercules’ by reforming humanist dependence on ancient texts as authoritative medicine. A knowledge of the theory and practice of Renaissance humanism discloses his identification with the Herculean labour of cleansing the Augean stable. He employed anatomical demonstration against Galen’s porous cardiac septum, which admitted blood across the ventricles. Harvey’s oath mehercule swore against Galen’s Dia to assert the necessity of opening an alternate route for the blood flow. His Herculean labour was to dam the cardiac septum and divert the blood flow into a continuous channel through the arteries and veins. His circulation of the blood also imitated Hercules’ successful dependence on the force of the water flow to flush the Augean stable. Harvey’s copia did not denote a quantitative amount but a powerful supply. Harvey aspired to be, like Hercules, immortal, a term which the College belatedly acknowledged. This cultural analysis exposes Harvey’s professional issues and personal ambitions, so to promote a fuller understanding of his historic role in medical discovery.

This article aims to explain why the notion of mania puerperalis, or puerperal insanity, was not used in the Netherlands to exonerate women accused of infanticide, in contrast to other countries. It applies the concept of ‘travelling knowledge’ as an approach to the history of forensic medicine, pointing to the fields of medicine and law as contact zones inviting, promoting or barring the transmission of knowledge. Although the notion of mania puerperalis was known in the Netherlands from 1822 on, psychiatric expertise was not requested in actual court cases of infanticide for several reasons. First, physicians and legal scholars continued to doubt the existence of this form of mania. Moreover, it was not always directly connected to infanticide. Also, the specific formulation of the law strongly determined what medical evidence was needed in court cases. Not only did the Code Pénal generally emphasise material evidence, the laws on infanticide specifically mentioned fear and therefore an additional reference to the mental condition of the accused was not needed. Most importantly, the article argues that the existing vocabulary on emotion, both vernacular and medical, already allowed for an analysis of psychic components.

The idea that smallpox could be eradicated was not necessarily the ultimate aim when inoculation was introduced in Europe in the 1720s. This potentiality was not clearly articulated as an aim until the end of the eighteenth century. This article argues that during most of the eighteenth century, the main aim of inoculation was to lead people as safely as possible through what was regarded as an unavoidable disease. Inoculation became safer, simpler and less expensive from the 1760s, but the changing ideas about its potentiality had more complex roots. A new understanding was produced through an interaction between inoculation practice, more general medical theory and developments within probabilistic thinking and political arithmetic. The first part of the article explores how smallpox inoculation was incorporated into existing medical thinking based on traditional humoral pathology. Inoculation was a new technology, but as it was perceived in the early eighteenth century, the innovation did not first and foremost concern the medical principles of the treatment. The second part of the article investigates arguments about why and when to inoculate: what kind of remedy was inoculation for eighteenth-century agents? The article concludes with a discussion on changes emerging towards the end of the century, and relates them to developments during the preceding decades rather than seeing them as inspired precursors of events and ideas to come.

In 1948 the New South Wales government instituted an inquiry into the claims of John Braund – a 78-year-old self-described ‘quack’ – that his secret treatment had cured 317 cancer sufferers. The ‘Braund controversy’, as it became known, was one of Australia’s most prominent cases of medical fraud. This paper examines that controversy and its effects on cancer philanthropy, medical research, and especially on legislation regulating treatment providers up to the present. With the Braund controversy in mind, the New South Wales (NSW) parliament struggled to develop legislation that would protect patients and punish quacks but also allow for serendipitous, unorthodox discoveries. Recent decades saw new elements added to this calculus – allowing a wide-ranging health marketplace, and allowing patients to choose their therapies. This paper argues that the particular body of law legislatures used in regulating cancer treatment and how regulations were framed reflected the changing context of healthcare and illustrates the calculus legislatures have undertaken in regulating the health marketplace, variously factoring in public safety, serendipitous discovery, the authority of orthodox medicine, patient choice, and economic opportunity.

The development of paediatric medicine as a formal field of medical specialisation is usually traced to the mid-nineteenth century at the earliest. While it is true that formal specialisation in children’s medicine was not, on the whole, typical for eighteenth-century medical practitioners, many displayed a deep and lasting interest in the diseases of children, and were consequently eager to develop therapeutic practices which could be targeted at infants and children. This led to a variety of attempts at innovation, many of which benefitted from the co-operation of, and opportunities afforded by, institutions. By examining the efforts of several medical practitioners at the London Foundling Hospital and at the Dispensary for the Infant Poor, this article explores how eighteenth-century medical practitioners used their affiliations with institutions to address the problems of devising or adapting therapeutic practices and treatments for children. In tailoring medical practice to suit children and, more specifically, in using institutions to do so, medical practitioners were demonstrating that child patients required special consideration, that children’s diseases could be managed medically and with the benefit of new approaches and methods, and that children’s health, as a whole, was the province of medical practitioners.

Irregular practitioners (‘quacks’) specialising in male sexual problems succeeded in nineteenth-century New Zealand by taking advantage of the growing population of unattached men who were ignorant of their own sexual physiology. The irregulars also profited from the regular practitioners’ acceptance of ill-defined or imaginary male sexual disorders and the side effects of conventional venereal disease treatments, the lack of a clear demarcation between quacks and the regular medical profession, and an increased availability of newspaper advertising. Improvements in the postal system enabled quacks to reach more potential customers by mail, their preferred sales method. The decline in quackery resulted from scientific advances in the understanding of disease and government legislation to privilege regular practitioners and limit quacks’ access to postal services and advertising.

This paper seeks to balance the regional and thematic focus of cholera historiography by examining maritime quarantine in Busan, as it was devised and implemented by Japanese officials and doctors during the pre-colonial period. It also places the relationship between Korea and Japan in the context of relations with China, Russia and Britain. This paper shows that quarantine measures in Busan and other Korean ports reflected the rise of Japanese imperial power and the increasing desire on the part of the Japanese to establish an effective borderline for their regional empire.

From 1879 Japan began to impose maritime quarantine in Busan, where Japanese influence was very strong even before the colonial period, though at that time Japan was unable to perform quarantine in its own ports independently due to the objections of Western powers, particularly Britain. Victories in the Sino-Japanese and Russo-Japanese wars established Japan as a regional power on equal terms with the West, and as the dominant power in Korea and Eastern Asia. With the acquisition of the right to impose quarantine in its homeland, Japan strengthened and extended the range of quarantine from Japan to Korea, China and Russia. Now quarantine screened Japan from potentially harmful agents – pathogenic and political – and its functions diversified further as modernisation and imperial expansion gathered pace. The reliance which Japan placed upon quarantine in maintaining its empire explains why it was increasingly out of step with other powers regarding international sanitary precautions. The Japanese maritime quarantine in Busan during this period therefore shows many aspects of Japan’s ‘national empire’.

Significant attention has been paid to the history of public health in England during the final part of the twentieth century. Within this, however, the field that came to be known as specialist health promotion (SHP) has been relatively neglected. Between 1980 and 2000 those working in this field, generally known as health promotion specialists (HPSs), enjoyed a relative rise in policy and practice prominence before SHP was effectively abandoned by government and others charged with developing and sustaining public-health structures. This paper seeks to explain why the fall of SHP is important; to move towards explaining its rise and decline; and to argue for greater historical attention to be paid to an important but neglected field within health and health care. Essentially, SHP emerged from a set of loose and contingent practices known as health education. A range of important social, economic, organisational and political influences contributed to the slow construction of a putative specialism in health promotion, accompanied by the desire on the part of some (but not all) HPSs to ‘professionalise’ their role. Finally the projects of both specialisation and professionalisation failed, again as a result of then prevailing organisational and political influences. The importance of such a failure in a so-called era of public health is discussed. In the light of this, the paper concludes by briefly setting out an agenda for further research related to the history of SHP.

Despite a varied historical literature on the nineteenth-century royal dockyards, very little has been written about the health issues associated with naval shipbuilding or the healthcare facilities that were provided for dockworkers in the period. This article focuses mainly on the latter. Drawing on archival sources from the home dockyards, an examination is made of the duties and responsibilities of dockyard surgeons. These are found to have expanded considerably as healthcare provision became steadily more comprehensive. It is argued that as providers to a civilian workforce, the naval authorities were in the vanguard when it came to implementing perceived advances in medical practice. It is also contended, however, that while many dockworkers benefited as a result, this positive appraisal needs to be set against the more ambiguous aspects of the surgeon’s role. Although surgeons treated the sick and injured, their growing prominence in other dockyard matters, such as retirement and the policing of sickness, is shown to have created tension in their relationship with the workforce.

Seirogan, a popular anti-diarrhoeal pill, is arguably one of the most successful pharmaceutical products of modern Japan. What is less known is that the Japanese army initially developed Seirogan during the Russo-Japanese War as the ‘Conquer-Russia-Pill’, which was later marketed to the public by private manufacturers. Previous scholars have emphasised the top–down governmental method of mobilising private sectors to manipulate public opinion for the cause of external imperialist expansion and domestic stability during wartime Japan. But the matrix that the Conquer-Russia-Pill allows us to glimpse is an inverted power relation among the state, commercial sectors, and imperial citizens. While the Japanese government remained indifferent if not hostile to jingoistic pharmaceutical manufacturers who could easily disrupt international relations, pharmaceutical companies quickly recognised and exploited the opportunities that the Conquer-Russia-Pill and its symbolism provided under the banner of the empire. In turn, Japanese consumers reacted to commercial sermons carefully anchored in patriotic and militaristic discourses and images by opening their wallets. In other words, the popularity of the Conquer-Russia-Pill was a culmination of the convergence of a governmental initiative to enhance military capabilities, the commercial ingenuity of pharmaceutical manufacturers, and a consumer response to patriotic exhortations.

In 1965 Jamaica was declared free of malaria by the World Health Organisation (WHO), thus ending centuries of death and suffering from the disease. This declaration followed the successful completion of the WHO’s Malaria Eradication Programme (MEP) on the island, initiated in 1958. This account first explores the antecedent control measures adopted by the government up to the MEP. These, as advocated by the previous malaria ‘experts’ who had reported on the disease on the island concentrated on controlling the vector and the administration of quinine for individual protection. Although Jamaica suffered no catastrophic epidemics of island-wide scope, malaria was a constant cause of mortality and morbidity. Major change came in the wake of the Second World War within the changing political context of national independence and international development. In 1957 the Jamaican government joined the global WHO programme to eradicate malaria. The Jamaican campaign exposes many of the problems noted in other studies of such top–down initiatives in their lack of attention to the particular circumstances of each case. Despite being described as ‘a textbook pattern’ of malaria eradication, the MEP in Jamaica suffered from a lack of sufficient preparation and field knowledge. This is most obviously illustrated by the fact that all literature on the programme sent to Jamaica in the first two years was in Spanish. That the MEP exploited the technological opportunity provided by dichlorodiphenyltrichloroethane (DDT) with advantage in Jamaica is not disputed but as this analysis illustrates this success was by no means guaranteed.

The first industrial hospital in America opened in 1840 in Lowell, Massachusetts. The Lowell Corporation Hospital was sponsored by the town’s textile employers for ninety years. This article analyses the contextual complications surrounding the employers’ sustained funding of the hospital. Motivations for sustained sponsorship included paternalism, clinical excellence, business custom, the labour situation in Lowell, civic duty and the political advantages of paternalism. By analysing the changing local context of the hospital, this article argues that a broader, more integrated approach to healthcare histories and institution histories is needed if we are to fully understand the myriad of healthcare providers and their local and national importance.