This article addresses the discussion about quinine-resistant malaria plasmodium in the early decades of the twentieth century. Observed by Arthur Neiva in Rio de Janeiro in 1907, the biological and social resistance of malaria sufferers to preventive and curative treatment with quinine was corroborated three years later by Oswaldo Cruz during the construction of the Madeira-Mamoré Railway in the Brazilian Amazon. Likewise in 1910, ailing German workers were transferred from Brazil to Hamburg’s Institute for Maritime and Tropical Diseases, where quinine resistance was confirmed by Bernard Nocht and Heinrich Werner. When the First World War saw failures in treating and preventing malaria with quinine along with violent outbreaks of the disease on the Turkish and Balkan fronts, resistance to this alkaloid became the topic of the day within the field of experimental medicine in Germany. New attempts were made to account for the resistance, especially by the physician Ernst Rodenwaldt, who explored the topic by applying modern theories on heredity. The present article offers a preliminary survey and analysis of pronouncements about quinine resistance, shedding new light on the circulation of knowledge in the field of tropical medicine.

This paper explores evolving conceptions and depictions of the human genome among human and medical geneticists during the postwar period. Historians of science and medicine have shown significant interest in the use of informational approaches in postwar genetics, which treat the genome as an expansive digital data set composed of three billion DNA nucleotides. Since the 1950s, however, geneticists have largely interacted with the human genome at the microscopically visible level of chromosomes. Mindful of this, I examine the observational and representational approaches of postwar human and medical genetics. During the 1970s and 1980s, the genome increasingly came to be understood as, at once, a discrete part of the human anatomy and a standardised scientific object. This paper explores the role of influential medical geneticists in recasting the human genome as being a visible, tangible, and legible entity, which was highly relevant to traditional medical thinking and practice. I demonstrate how the human genome was established as an object amenable to laboratory and clinical research, and argue that the observational and representational approaches of postwar medical genetics reflect, more broadly, the interdisciplinary efforts underlying the development of contemporary biomedicine.

Based on a wide range of primary materials, including WHO reports and Colonial Office correspondence, this article examines the UNICEF/WHO-funded mass BCG campaigns that were carried out in seven Caribbean colonies between 1951 and 1956. It explores the reasons behind them, their nature and aftermath and also compares them to those in other non-European countries and discusses them within a context of decolonisation. In doing so, it not only adds to the scholarship on TB in non-European contexts, which had tended to focus on Africa and Asia, but also to the relatively new field of Caribbean medical history and the rapidly expanding body of work on international health, which has paid scant attention to the Anglophone Caribbean and the pre-independence period.

Although historians have shown that there has been a complex and multi-layered relationship between the body, medicine and the force of electricity, many avenues remain to be explored. One of the most prominent of these is the way in which electrotherapy technologies were marketed to a wide variety of different end users and intermediaries. This paper offers the first historical analysis of one such device – the Overbeck Rejuvenator – a 1920s electrotherapy machine designed for use by the general public. Its inventor, Otto Overbeck, was not a medical man and this enabled him to use aggressive strategies of newspaper advertising, using testimonials to market his product alongside appeals to his own scientific authority. He commissioned the prestigious Ediswan Company to manufacture the Rejuvenator on a large scale, and took out patents in eleven countries to persuade users of the efficacy of the device. In response to Overbeck’s activities, the British Medical Association enlisted an electrical engineer to examine the Rejuvenator, contacted practitioners whose endorsements were being used in publicity material, and denied Overbeck permission to advertise in the British Medical Journal. Despite this, the Rejuvenator brought its inventor wealth and notoriety, and helped redefine the concept of ‘rejuvenation’, even if the professional reception of such a device was almost universally hostile. This paper shows how the marketing, patenting and publishing of Overbeck combined to persuade members of the laity to try the Rejuvenator as an alternative form of therapy, bypassing the medical profession in the process.

This paper analyses how the Colombian medical elites made sense of typhoid fever before and during the inception of bacteriological ideas and practices in the second half of the nineteenth century. Assuming that the identity of typhoid fever has to be understood within the broader concerns of the medical community in question, I show how doctors first identified Bogotá’s epidemics as typhoid fever during the 1850s, and how they also attached specificity to the fever amongst other continuous fevers, such as its European and North American counterparts. I also found that, in contrast with the discussions amongst their colleagues from other countries, debates about typhoid fever in 1860–70 among doctors in Colombia were framed within the medico-geographical scheme and strongly shaped by the fear of typhoid fever appearing alongside ‘paludic’ fevers in the highlands. By arguing in medico-geographical and clinical terms that typhoid fever had specificity in Colombia, and by denying the medico-geographical law of antagonism between typhoid and paludic fevers proposed by the Frenchman Charles Boudin, Colombian doctors managed to question European knowledge and claimed that typhoid fever had distinct features in Colombia. The focus on paludic and typhoid fevers in the highlands might explain why the bacteriological aetiology of typhoid fever was ignored and even contested during the 1880s. Anti-Pasteurian arguments were raised against its germ identity and some physicians even supported the idea of spontaneous origin of the disease. By the 1890s, Pasteurian knowledge had come to shape clinical and hygienic practices.

Alexander of Tralles, writing in the late sixth century, combined his wide-ranging practical knowledge with earlier medical theories. This article shows how clinical experience is used in Alexander’s works by concentrating on his therapeutic advice on epilepsy and, in particular, on pharmacology and the group of so-called natural remedies. I argue that clinical testing is used not only for the introduction of new medicines but also as an instrument for checking the therapeutic effect of popular healing practices. On another level, this article discusses Alexander’s role as the author of a medical compendium; it suggests that by marking the cases of clinical testing with a set of recurrent expressions, Alexander leads his audience to reflect on his medical authority and personal contribution.

Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a ‘permanent disease of the brain’, and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study’s genealogical lens examines one white settler male patient’s experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry’s ‘case’ interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of ‘patient’ and ‘family’ in colonial life, c.1888–1918, and considers the calamity, uncertainty, stigma and silences of mental illness.

Charles Singer’s retrospective diagnosis of Hildegard of Bingen as a migraine sufferer, first made in 1913, has become commonly accepted. This article uses Hildegard as a case study to shift our focus from a polarised debate about the merits or otherwise of retrospective diagnosis, to examine instead what happens when diagnoses take on lives of their own. It argues that simply championing or rejecting retrospective diagnosis is not enough; that we need instead to appreciate how, at the moment of creation, a diagnosis reflects the significance of particular medical signs and theories in historical context and how, when and why such diagnoses can come to do meaningful work when subsequently mobilised as scientific ‘fact’. This article first traces the emergence of a new formulation of migraine in the nineteenth century, then shows how this context enabled Singer to retrospectively diagnose Hildegard’s migraine and finally examines some of the ways in which this idea has gained popular and academic currency in the second half of the twentieth century. The case of Hildegard’s migraine reminds us of the need to historicise scientific evidence just as rigorously as we historicise our other material and it exposes the cumulative methodological problems that can occur when historians use science, and scientists use history on a casual basis.

During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain’s leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient’s military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria.

This article examines hospital provision in Ireland during the early twentieth century. It examines attempts by the newly independent Irish Free State to reform and de-stigmatise medical relief in former workhouse infirmaries. Such reforms were designed to move away from nineteenth century welfare regimes which were underpinned by principles of deterrence. The reform initiated in independent Ireland – the first attempted break-up of the New Poor Law in Great Britain or Ireland – was partly successful. Many of the newly named County and District Hospitals provided solely for medical cases and managed to dissociate such health care provision from the relief of poverty. However, some hospitals continued to act as multifunctional institutions and provided for various categories including the sick, the aged and infirm, ‘unmarried mothers’ and ‘harmless lunatics’. Such institutions often remained associated with the relief of poverty. This article also examines patient fee-payment and outlines how fresh terms of entitlement and means-testing were established. Such developments were even more pronounced in voluntary hospitals where the majority of patients made a financial contribution to their treatment. The article argues that the ability to pay at times determined the type of provision, either voluntary or rate-aided, available to the sick. However, it concludes that the clinical condition of patients often determined whether they entered a more prestigious voluntary hospital or the former workhouse. Although this article concentrates on two Irish case studies, County Kerry and Cork City; it is conceptualised within wider developments with particular reference to the British context.

This article discusses a Latin manuscript that can be found in the Jan Baptist Van Helmont (1579–1644) archives in Mechelen (Malines), Belgium. The manuscript bears no author and no title, and begins with the words ‘Exterior homo’, hence being referred by this provisional title in the analysis. Ecclesiastical prosecutors investigating Van Helmont for heresy in 1634 considered that it was written by him, but this was vehemently denied by the Flemish physician. The present article takes a first detailed look at the content of the treatise and ideas contained therein. It hence identifies the manuscript as belonging to a seventeenth-century physician influenced by the ideas of Theophrastus Paracelsus (1493–1541) and his interpreter Petrus Severinus (1542–1602), and containing a complex medical philosophy drawn on alchemical thought. Thus, the anonymous author presents a comprehensive view on the nature and structure of man, as well as an idiosyncratic theory of human generation. Following the analysis of the treatise, the article further compares it with the known works of J.B. Van Helmont, and finds that it is very similar to his ideas. Hence, the article concludes that it is ‘likely’ that the manuscript is indeed written by Van Helmont, although lack of direct evidence prevents certain attribution.

For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital’s longevity and particular character, or ‘organisational culture’: the ethos of a ‘McCord Family’, integral to which were faith and a commitment to service. While recognising that families – including ‘hospital families’ like that at McCord – are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of ‘a McCord family’ was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital’s founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this ‘family ethos’ was constructed and what made it so attractive to this hospital’s staff, trainees and patients. Furthermore, we consider what ‘work’ it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and ‘families’ intersect may be of value for the future of hospitals as well as of interest in their past.

This article focuses on the function of the convict prison infirmary and views it as a site of arbitration, resistance and ‘contested power’. In accordance with the rules and regulations periods of incarceration in convict prisons began and ended with an obligatory medical examination. While the primary function of the initial test was to measure the convict body in order ascertain physical ability to conduct hard labour it also provided a thorough bio-metrical description for future identification purposes. The final examination was not as comprehensively undertaken but also concerned itself with anthropometrical observations. It would be reasonable to assume that the balance of power was weighted in the authority’s favour but this research has found evidence to the contrary. For instance, that there was a fair degree of physiological knowledge within the convict population and that some convicts used the infirmary for dietary gains and reprieve from hard labour. Using body mass index (BMI) as an instrument to measure physical wellbeing this article views the doctor–convict interface as a crucial component of the penal experience. It analyses 251 convict medical records to show that the balance of diet and work led to what might be considered a counterintuitive outcome – a preponderance of weight gain, particularly for males in Irish prisons.

In 1856, the mayor of Brussels proposed the establishment of a municipal laboratory with a chemist to analyse food and beverages to restrain fraud. His proposal was accepted and a laboratory – possibly one of the first municipal laboratories in Europe – was set up. The laboratory still exists today. This paper aims at tracing the conditions in which it emerged, situating it within the laissez-faire context of the time. It was brought into existence by a liberal administration, in a period of little interventionism replete with unencumbered private interests (those of bakers, butchers, grocers, millers, pharmacists, doctors and so on). What will be considered here is the general mood with regard to food fraud, fair trade, correct price, and the quality of food in the first half of the nineteenth century. On a broader level, this contribution addresses the frictions between private and public initiative, while focusing on the process of construction of expertise. The paper makes use of contemporary documents such as reviews, newspapers, association reports and city council chronicles.

Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell’s death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell’s case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo’s public performances elided with Bell’s descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner.

The concept of a healthy skin penetrated the lives of many people in late-nineteenth-century Britain. Popular writings on skin and soap advertisements are significant for pointing to the notions of the skin as a symbolic surface: a visual moral ideal. Popular health publications reveal how much contemporary understanding of skin defined and connected ideas of cleanliness and the visual ideals of the healthy body in Victorian Britain. Characterised as a ‘sanitary commissioner’ of the body, skin represented the organ of drainage for body and society. The importance of keeping the skin clean and purging it of waste materials such as sweat and dirt resonated in a Britain that embraced city sanitation developments, female beauty practices, racial identities and moral reform. By focusing on the popular work by British surgeon and dermatologist Erasmus Wilson (1809–84), this article offers a history of skin through the lens of the sanitary movement and developments in the struggle for control over healthy skin still in place today.

After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman’s life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country’s newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary’s stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their ‘duty’ to procreate within marriage. Ultimately, the event encapsulated a great deal about elites’ attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa’s extremely restrictive Abortion and Sterilisation Act (1975).

The Companhia de Diamantes de Angola, or Diamang, mined for diamonds in colonial Angola from 1917 until independence in 1975. The enterprise’s Health Services Division (SSD) was responsible for supplying mine managers with an African labour force comprised of healthy, and therefore productive, employees. In practice, though, this otherwise ‘healthy’ system did not always work. While SSD personnel attempted to fulfil their charge by implementing a series of screening measures, production targets and a scarcely-populated regional labour pool regularly prompted senior officials to compel the SSD to clear recruits who were otherwise unfit for mine service. Drawing upon interviews with former SSD staff and African labourers, as well as company and colonial archival sources, this article focuses on the interplay over time between the SSD, the company’s production demands and these labourers.