The De humani corporis fabrica [The Fabric of the Human Body], Basle, 1543, of Andreas Vesalius is deservedly famous as the first modern book of anatomy. A second edition was published in Basle in 1555, but little is known of Vesalius’ activities after that date. This article discusses a recent find: Vesalius’ own copy of the 1555 edition, heavily annotated in preparation for a never published third edition. Vesalius made hundreds of changes to the second edition, the great majority being stylistic, altering the Latin words but not the overall meaning. There are also changes to the plates to give greater clarity or to correct mistakes by the original block-cutter. There is little new anatomical material, although Vesalius continued to meditate about what he had earlier discovered. He shows no sign of being acquainted with the findings of others, like Colombo or Falloppia, that were published after he had moved his residence from Brussels to Spain in summer 1559, perhaps leaving this volume behind. The number of annotations shows Vesalius’ passionate concern not only for accuracy but also for the most effective way of proclaiming his new anatomical message.

Medical History is embarking on an exciting new journey. Thanks to the Wellcome Trust, the ownership of this journal has passed to Cambridge University Press. The Press is committed to running the publication as its flagship journal in the history of medicine, related sciences and health, and is keen to offer authors full flexibility when it comes to publishing and archiving their articles. Medical History's editorial office has moved to the Centre for Global Health Histories at the University of York, which is housed within its Department of History; the Centre and Department are honoured to be associated to this world-leading journal.

The modern notion of sexuality took shape at the end of the nineteenth century, especially in the works of Richard von Krafft-Ebing and Albert Moll. This modernisation of sexuality was closely linked to the recognition of sexual diversity, as it was articulated in the medical–psychiatric understanding of what, at that time, was labelled as perversion. From around 1870, psychiatrists shifted the focus from immoral acts, a temporary deviation of the norm, to an innate morbid condition. In the late nineteenth century, several psychiatrists, collecting and publishing more and more case histories, classified and explained the wide range of deviant sexual behaviours they traced. The emergence of medical sexology meant that perversions could be diagnosed and discussed. Against this background both Krafft-Ebing and Moll articulated a new perspective, not only on perversion, but also on sexuality in general. Krafft-Ebing initiated and Moll elaborated a shift from a psychiatric perspective in which deviant sexuality was explained as a derived, episodic and more or less singular symptom of a more fundamental mental disorder, to a consideration of perversion as an integral part of a more general, autonomous and continuous sexual instinct. Before Sigmund Freud and others had expressed similar views, it was primarily through the writings of Krafft-Ebing and Moll that a new understanding of human sexuality emerged.

Andreas Vesalius' (1514–64) first publication was a Paraphrasis of the ninth book of the Liber ad Almansorem, written by the Arab–Persian physician and alchemist Rhazes (854–925). The role of Rhazes in Vesalius' oeuvre has thus far been much disregarded. The different ways Rhazes recurs reveal an intellectual evolution in Vesalius' work. In the Paraphrasis, Vesalius subjects Rhazes to the authority of Galen in the context of the early sixteenth-century humanist campaign for the substitution of Arab influences by Greek ‘originals’. Over the years Vesalius continues his work on Rhazes, but his approach becomes more internationalistic. Ultimately, Vesalius criticises Galen while expressing sympathy for the Arab author. This may be the more significant as Rhazes could have influenced Vesalius in the act of criticising Galen – critical discussions of Galen were available to Vesalius in Latin translations of Rhazes's Liber Continens. Although Vesalius never refers to the work, it is hardly possible he was unaware of it: similarities in structure, rhetoric and form between the Continens and the De humani corporis fabrica could support this hypothesis.

The activities of Irish medical practitioners in relieving the impact of the Irish Famine (c.1845–52) have been well documented. However, analysis of the function of contemporary medico-scientific ideas relating to food has remained mostly absent from Famine historiography. This is surprising, given the burgeoning influence of Liebigian chemistry and the rising social prominence of nutritional science in the 1840s. Within this article, I argue that the Famine opened up avenues for advocates of the social value of nutritional science to engage with politico-economic discussion regarding Irish dietary, social and economic transformation. Nutritional science was prominent within the activities of the Scientific Commission, the Central Board of Health and in debates regarding soup kitchen schemes. However, the practical inefficacy of many scientific suggestions resulted in public associations being forged between nutritional science and the inefficiencies of state relief policy, whilst emergent tensions between the state, science and the public encouraged scientists in Ireland to gradually distance themselves from state-sponsored relief practices.

This paper examines the origins of aseptic surgery in the German-speaking countries. It interprets asepsis as the outcome of a mutual realignment of surgery and laboratory science. In that process, phenomena of surgical reality were being modelled and simplified in the bacteriological laboratory so that they could be subjected to control by the researcher’s hands and eyes. Once control was achieved, it was being extended to surgical practice by recreating the relevant features of the controlled laboratory environment in the surgical work place. This strategy can be seen in the adoption of Robert Koch’s bacteriology by German-speaking surgeons, and the resulting technical changes of surgery, leading to a set of beliefs and practices, which eventually came to be called ‘asepsis’.

This article examines the career and reform agenda of Christopher Merrett as a means of evaluating the changing conditions of medical knowledge production in late seventeenth-century London. This period was characterised by increasing competition between medical practitioners, resulting from the growing consumer demand for medical commodities and services, the reduced ability of elite physicians to control medical practice, and the appearance of alternative methods of producing medical knowledge – particularly experimental methods. This competition resulted in heated exchanges between physicians, apothecaries, and virtuosi, in which Merrett played an active part. As a prominent member of both the Royal Society and the Royal College of Physicians, Merrett sought to mediate between the two institutions by introducing professional reforms designed to alleviate competition and improve medical knowledge.These reforms entailed sweeping changes to medical regulation and education that integrated the traditional reliance on Galenic principles with knowledge derived from experiment and artisanal practices. The emphasis Merrett placed on the trades suggests the important role artisanal knowledge played in his efforts to reorganise medicine and improve knowledge of bodily processes.

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 rarely took 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 paper analyses how, prior to the work of Sigmund Freud, an understanding of infant and childhood sexuality emerged during the nineteenth century. Key contributors to the debate were Albert Moll, Max Dessoir and others, as fin-de-siècle artists and writers celebrated a sexualised image of the child. By the beginning of the twentieth century, most paediatricians, sexologists, psychologists, psychiatrists, psychoanalysts and pedagogues agreed that sexuality formed part of a child’s ‘normal’ development. This paper argues that the main disagreements in discourses about childhood sexuality related to different interpretations of children’s sexual experiences. On the one hand stood an explanation that argued for a homology between children’s and adults’ sexual experiences, on the other hand was an understanding that suggested that adults and children had distinct and different experiences. Whereas the homological interpretation was favoured by the majority of commentators, including Moll, Freud, and to some extent also by C.G. Jung, the heterological interpretation was supported by a minority, including childhood psychologist Charlotte Bühler.

The historiography of medicine in South Asia often assumes the presence of preordained, homogenous, coherent and clearly-bound medical systems. They also tend to take the existence of a medical ‘mainstream’ for granted. This article argues that the idea of an ‘orthodox’, ‘mainstream’ named allopathy and one of its ‘alternatives’ homoeopathy were co-produced in Bengal. It emphasises the role of the supposed ‘fringe’, ie. homoeopathy, in identifying and organising the ‘orthodoxy’ of the time. The shared market for medicine and print provided a crucial platform where such binary identities such as ‘homoeopaths’ and ‘allopaths’ were constituted and reinforced. This article focuses on a range of polemical writings by physicians in the Bengali print market since the 1860s. Published mostly in late nineteenth-century popular medical journals, these concerned the nature, definition and scope of ‘scientific’ medicine. The article highlights these published disputes and critical correspondence among physicians as instrumental in simultaneously shaping the categories ‘allopathy’ and ‘homoeopathy’ in Bengali print. It unravels how contemporary understandings of race, culture and nationalism informed these medical discussions. It further explores the status of these medical contestations, often self-consciously termed ‘debates’, as an essential contemporary trope in discussing ‘science’ in the vernacular.

This paper readdresses the assertion found in much secondary literature that Greek medicine was adopted in Tibet in the seventh and eighth centuries. I discuss some of the traces of Galenic medical knowledge in early Tibetan medicine, and raise the question of why Tibetan medical histories who mention Galen give Galenic medicine a much more significant place than is evidenced in the Tibetan medical literature itself. I discuss some historiographical considerations and argue that the centrality given to Galenic medicine is more indicative of the period in which these sources are written than of the period which they presumably describe.

Albert Moll was one of the most influential sexologists during the first three decades of the twentieth century. In contrast to his rivals Sigmund Freud and Magnus Hirschfeld, his achievements have not yet been recognised adequately. The author gives a comparative account of the work of these three protagonists. This shows that Moll formed some ideas which are regarded as psychoanalytical today before Freud, and that he, in contrast to Hirschfeld, was able to reflect critically on contemporary discourses, such as the debates on racial improvement through eugenics. As scientific theories, Freud’s psychoanalysis represented the unconscious, fantasy, experience and latency, while Moll’s sexology represented consciousness, ontological reality, behaviour and manifestation. Moll’s major disagreement with Hirschfeld’s sexology was his advocacy of apolitical and impartial science, whereas Hirschfeld’s aim was to achieve sexual reforms politically. Added to these differences were strong personal animosities. Freud called Moll a ‘beast’ and ‘pettifogger’; and Moll complained about Hirschfeld’s ‘problematic’ character. When Hirschfeld escaped the Nazi terror and went to Paris, Moll denounced him in order to prevent him rebuilding a new existence in exile.

This article reconstructs the process of defining influenza as an infectious disease in the contexts of British medicine between 1890 and 1914. It shows how professional agreement on its nature and identity involved aligning different forms of knowledge produced in the field (public health), in the clinic (metropolitan hospitals) and in the laboratory (bacteriology). Two factors were crucial to this process: increasing trust in bacteriology and the organisation of large-scale collective investigations into influenza by Britain’s central public authority, the Medical Department of the Local Government Board. These investigations integrated epidemiological, clinical and bacteriological evidence into a new definition of influenza as a specific infection, in which a germ – Bacillus influenzae – was determined as playing a necessary but not sufficient role in its aetiology, transmission and pathogenesis. In defining ‘modern influenza’, bacteriological concepts and techniques were adapted to and selectively incorporated into existing clinical, pathological and epidemiological approaches. Mutual alignment thus was crucial to its construction and, more generally, to shaping developing relationships between laboratory, clinical and public health medicine in turn-of-the-century Britain. While these relationships were marked by tension and conflict, they were also characterised by important patterns of convergence, in which the problems, interests and practices of public health professionals, clinicians and laboratory pathologists were made increasingly commensurable. Rather than retrospectively judge the late nineteenth-century definition of influenza as being based on the wrong microbe, this article argues for the need to examine how it was established through a particular alignment of medical knowledge, which then underpinned medical approaches to the disease up to and beyond the devastating 1918–19 pandemic.

This article summarises the findings of recent work on local authority public hospital services in England and Wales in the inter-war years and identifies the lack of a robust hypothesis to explain the variations found, particularly one that would explain the actions of county councils as well as county boroughs. Using public policy techniques on a group of local authorities in the far South West it proposes that variations can be explained by an understanding of the deep core beliefs of councillors, their previous experience of ‘commissioner’ and ‘provider’ roles, and the availability or otherwise of a dedicated policy entrepreneur to promote change.

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.

This paper examines the reasons why Physician He (Yi–He, sixth century BCE) was regarded as a founder in the classical medical tradition of China. By most accounts, Physician He’s importance owes much to his theoretical innovations. In contrast to earlier healers, Physician He purportedly framed the aetiology of illnesses solely in terms of natural causes, as opposed to attributing sickness to gods or demons. In this paper, I reread a famous episode in the Commentary by Zuo, which is often cited as evidence of the physician’s naturalism. By paying close attention to the formal elements of the narrative as well as its larger discursive context, I argue that the standard reading of Physician He falls short. The episode provides little evidence of any secular challenge to religious conceptions of illness, and Physician He was, in fact, patterned after occult experts. A careful look moreover at the reception of Physician He in premodern histories of medicine reveals that the physician was extolled for his attunement to the will of the spirits as well as his powers of examination. Physician He’s reputation as a naturalist furthermore represents a modern interpretation, one that reflects efforts to defend the indigenous medical tradition against its biomedical detractors.

Using court records involving the expert testimony of the Berlin sexologist Albert Moll, my article demonstrates that during the early 1920s a shift in the ‘epistemologies of justice’ concerning the adjudication of sex crimes took place within German courtrooms. Namely, presiding judges considered a greater number of sexual acts as punishable, despite no change in the laws themselves. Central to my argument is the role of expert testimony in practice and its critical reception. By focusing upon the rhetorical strategies presented by attorneys, judges and expert witnesses (as well as defendants themselves and their relatives), it illustrates the functions of expert and tacit knowledge in court, which were often not mutually exclusive. Moll’s stature also enabled him to translate his scientific–medical expertise into state support for his testimonies, as well as the rebuilding of an international community of sexological authorities. It was only under Moll’s leadership that the First International Sexology Congress could take place in 1926, an event that marked the apex of his prestige.

Legionnaires’ disease is now routinely discussed as an ‘emerging infectious disease’ (EID) and is said to be one of the earliest such diseases to be recognised. It first appeared in 1976 and its cause was identified in 1977, the same year that Ebola fever, Hantaan virus and Campylobacter jejuni arrived. The designation of Legionnaires’ disease as an EID was retrospective; it was not and could not be otherwise as the category only gained currency in the early 1990s. In this article we reflect on the changing medical understanding and social profile of Legionnaires’ disease in the decade or so from its recognition to the creation of EIDs, especially its ambivalent position between public health and clinical medicine. However, we question any simple opposition, between public health experts who approached Legionnaires’ disease as a new and worrying environmental threat that could be prevented, and clinicians who saw it as another cause of pneumonia that could be managed by improved diagnosis and treatment. We argue that in the British context of public spending cuts and the reform of public health, the category of ‘new’ diseases, in which Legionnaires’ disease was central, was mobilised ahead of the EID lobby of the early 1990s, by interested groups in medicine to defend infectious diseases services.