In this conclusion, Stephen T. Casper reviews themes and findings from the entirety of the collection. He situates the book as a whole as a provocation to reconsider the traditional historiographic approach in the history of the human sciences.

This chapter looks through the earliest establishment of immediate care, from historical records and the beginnings of some of the longest running pre-hospital services, especially those in the UK. It outlines an understanding of the foundations from which the advances in technology and clinical practice for modern pre-hospital emergency medicine are built. It outlines trauma care, and the evolution of treatments, equipment, and resources. It examines each facet of immediate care to encompass the range of triage and dispatch, lifesaving interventions, medicines, cardiac arrest management, and training and non-technical skills. Also examined are the potential developments in the equipment and strategies for resuscitation, along with aspects of what may be on the horizon for research and service development in the near future. It provides the most up-to-date overview of immediate care, which forms a vitally important component of each trauma patient’s journey from injury to recovery.

In the first chapter I introduce some methodological issues pertaining to the history of mental health: on the one hand, the issue of anachronism, the problem of retrospective diagnosis, on the other, the importance of maintaining intelligibility across cultures. When it comes to the ancient world, there are specific problems related to the nature of medical sources in Greek and Latin, and our limited access to the medical practices underlying them; in addition, the genre 'biography of disease' has its own pitfalls, namely those of attributing ‘essence’ to what appears, prima facie, to be most of all a construct: a disease concept or label such as phrenitis. Finally, in this chapter I consider the label phrenitis, its etymological meanings and the implications of the name vis-à-vis localization (chest? lungs? diaphragm? heart?) and mental life (mind? character? soul? mental capacities?). I also discuss the ‘Homeric’ appeal of the phrēn/phrenes, the name of the body part from which the label originates. The poetic archaism of phrēn/phrenes combined with its medical use made it both understandable as a generic term for mental life and specifically a ‘medical’ term to indicate the diaphragm, and contributed to making phrenitis a long-lasting disease concept.

This chapter aims to engage with decolonizing turns within the history of medicine as a set of sources and as a discipline and will consider how such readings and pedagogical choices might help us reflect upon a decolonizing turn within the English literary curriculum. Literary sources intersect seamlessly with histories of medicine, science, disability, and emotion. However, it is still possible that history and literature as complementary but starkly different methodologies rarely reflect adequately on one’s disciplinary borrowings from the other. This chapter is an attempt to facilitate such a conversation and knowledge exchange. For my purposes, I define “literature” for the historian in a way that incorporates a broader range of “creative” writing, including ethnography, memoir, psychological or psychoanalytic notetaking, and polemics.

The invention of the stethoscope by the French physician René Laennec in 1816 was a pivotal moment in the burgeoning field of modern clinical diagnosis. It brought the inner soundscape of the human body – an invisible realm which largely existed beyond the range of the human ear – into not only medical but also more general cultural awareness. This chapter considers the stethoscope as the subject not of ongoing scientific debate and experimentation, but of poetry and fiction, as tales of its use and abuse, as well as its supposed powers, spread among those who first encountered it and sowed a more general sense of confusion, mistrust, and corporeal anxiety in relation to the medical consultation. Drawing on interactions with the stethoscope in works by Wilkie Collins, Bram Stoker, Mary Elizabeth Braddon, and Sheridan Le Fanu, as well as short stories and poetry from popular periodicals, I demonstrate that, as medical institutions accepted new technologies and became increasingly specialized throughout the century, the stethoscope became for many patients an object of anxious contemplation, serving as a palpable interface between doctor and patient, between hope and fear, and between the visible and the invisible.

This chapter describes, and transcribes in full, a Reminiscence event in which ten original members of the audience of the 1979 lecture were invited to talk about their impressions of the meeting forty years before. They describe the atmosphere and reflect on how things were considered then and now. Notes explaining other relevant work and biographies of individuals mentioned are appended.

Chapter 5 examines how the Great Plague Scare unfolded in the entangled colonial empires of France and Spain. Despite their intertwined histories in the early-eighteenth-century Atlantic, few works in the English language have focused on Franco-Spanish colonial relations. The chapter describes the orders coming from the metropoles for dealing with the threat of plague and analyzes how those on the ground ultimately responded. In the end, it answers the question, what was different in the colonies? It opens in Fort Royal, Martinique, where a major scandal unfolded when a French vessel arrived from the Languedocien port of Sète. What I call the “Sète affair” offers the opportunity to examine the “spirit of sedition” that endured in the French Antilles well before the Age of Revolution. The chapter then transitions to plague-time violence and Franco-Spanish relations in the Caribbean and demonstrates that the demands of the metropole were not always in line with the needs or wants of the people in the overseas colonies. On the surface, disaster centralism during the Plague of Provence seemed to extend from Europe to the colonies, but on the ground, local needs and economic concerns often outweighed the demands of a far-flung ruler.

Chapter 2 explores reactions to the Plague of Provence in Italy with a focus on the port city of Genoa, considered by some to be “l’état le plus exposé,” or “the most exposed” to the threat of plague by its proximity to Marseilles. The chapter begins with a brief introduction to Genoa’s rich history of quarantine and public health. It then examines how a campaign of misinformation perpetuated by officials in Marseilles affected the reception of news about the plague outside of France. Claims that the disease was merely a malignant fever, or that the outbreak had ended (when it had not) caused confusion in the first months of the outbreak. Nevertheless, the inevitable truth that plague was in France began to arrive in cities across Europe via envoys, ambassadors, and especially via consuls, who reported back to their respective states from Provence. From there, word traveled rapidly as these accounts were copied in letters and printed in newspapers across Europe and the colonies, creating what I term an “invisible commonwealth” based in contemporary communication networks. The chapter then examines responses to the Provençal plague in Genoa and how they influenced, or were influenced by, Italian trade and diplomacy.

Chapter 1 lays the groundwork for the rest of the book by addressing the emergence of plague in the port city of Marseilles and its spread into southeastern France. It tells the story of the Grand Saint-Antoine, the infamous vessel that allegedly transported the plague to France from the Levant in 1720. It then situates this traditional narrative within the context of recent genetic studies that call its accuracy into question. Although the science has not yet been able to disprove the accepted historical explanation for the outbreak – which is to say, that the pathogen arrived on the ill-fated vessel – it has offered a valuable opportunity to revisit traditional understandings of disease as a product of the “orient,” and to examine and appreciate the influence of new technologies – in this case, genomic DNA analysis – on historical research and our interpretations of archival documents. The chapter moves on to discuss civil and religious responses to the epidemic and what I argue was the implementation of disaster centralism in France, as authorities in Paris stepped in to mitigate the threat of infection from Provence before it spread any further.

From 1720 to 1722, the French region of Provence and surrounding areas experienced one of the last major epidemics of plague to strike Western Europe. The Plague of Provence (or Great Plague of Marseilles) was a major disaster that left in its wake as many as 126,000 deaths, as well as new understandings about the nature of contagion and how best to manage its threat. Although the infection never left southeastern France, all of Europe, the Mediterranean, the Atlantic, and parts of Asia mobilized against its threat, and experienced its social, commercial, and diplomatic repercussions. Accordingly, this transnational study explores responses to this biological threat in some of the foremost port cities of the eighteenth-century world, including Marseilles, Genoa, London, Cádiz—the principal port for the Carrera de Indias or Route to the Indies – as well as some of the principal colonial towns with which these cities were most closely associated. In this way, this book reveals the ways in which a crisis in one part of the globe can yet transcend geographic and temporal boundaries to influence society, politics, and public health policy in regions far removed from the epicenter of disaster.

From 1720 to 1722, the French region of Provence and surrounding areas experienced one of the last major epidemics of plague to strike Western Europe. The Plague of Provence (or Great Plague of Marseilles) was a major disaster that left in its wake as many as 126,000 deaths, as well as new understandings about the nature of contagion and how best to manage its threat. Although the infection never left southeastern France, all of Europe, the Mediterranean, the Atlantic, and parts of Asia mobilized against its threat, and experienced its social, commercial, and diplomatic repercussions. Accordingly, this transnational study explores responses to this biological threat in some of the foremost port cities of the eighteenth-century world, including Marseilles, Genoa, London, Cádiz—the principal port for the Carrera de Indias or Route to the Indies – as well as some of the principal colonial towns with which these cities were most closely associated. In this way, this book reveals the ways in which a crisis in one part of the globe can yet transcend geographic and temporal boundaries to influence society, politics, and public health policy in regions far removed from the epicenter of disaster.