This article examines the place of habit in the medical thought and practices of 18th-century Britain. Scholars, including Steven Shapin and Phil Withington, have shown that habit was important to the broadly humoral understandings of health, disease, and regimen that dominated in Europe for much of the early modern period. In this article, I offer the first sustained attempt to understand the role of habit in the medical thought of 18th-century Britain, focusing on the influential Scottish physician William Cullen. For the first time engaging with all of Cullen’s work on habit, including his correspondence, pathological lectures, and clinical lectures, I show that medics of the 18th century developed a new understanding of habit, linked to changing ideas about the nervous system. Increasingly, they emphasised the role that habit could play in causing the periodical return of bodily functions, even when there appeared to be no plausible physical cause. In so doing, medics engaged with one of the key debates of the 18th century – the contested notion that human nature itself might be contingent on social and environmental conditions. For them, habit provided the means by which society could quite literally change the body. These ideas come through clearly in the striking suggestion – hitherto unnoticed – that menstruation was the product of habit, arising not from nature but from culture. Discussions of menstruation reveal the political stakes of habit, with links to highly contested debates about the role that bodies of different genders might play in society.

This article examines Charles Bell’s experimental practices by drawing historiographical attention away from the priority disputes over the spinal nerve functions for which he was most famous. I argue that Bell’s primary research interest was the expression of emotions. To this end, he developed a programme of vivisection that explored the underlying mechanisms of emotion. However, this also resulted in a profound contradiction between his experimental practices and his worldview – conducting painful experiments on beloved animals despite moral revulsion towards animal experimentation. This opens up three interconnected areas. Firstly, it allows an exploration of disciplinary identity in medicine, particularly the way that disciplines demanded specific practices and behaviours. Secondly, vivisection more generally required methods and ethics that opposed the growing anti-cruelty voice. Here, a combination of animal choice and the importation of techniques from the slaughterhouses was critical. Thirdly, vivisectors navigated a complex emotional landscape between their professional obligations and broader cultural sensibilities. These three areas are linked together using Boddice’s concept of moral economies, the affective frameworks that structured feelings. Particularly important were the sentimental and Romantic economies, both of which impacted Bell and his research. At the same time, Bell always struggled to reconcile the tensions between his disciplinary identity and his sentimental and Romantic beliefs, ultimately leading him to abandon experimentation after his assistant John Shaw’s death. I conclude by identifying the guarantees provided by character for licensing ostensibly cruel behaviours, thus allowing for the maintenance of probity within competing moral economies.

This special issue, which brings together six articles, seeks to explore the question of madness from non-European contexts (Latin America and Africa), taking part in the dynamic renewal of historiography on mental disorder and psychiatry in the ‘Global South’ over the past few years.1

Since Foucault’s seminal work in the 1960s on the consequences of eighteenth-century discursive shifts in medicine, the establishment of hospitals during this period has often been interpreted as a progressive innovation driven primarily by medical scientists. However, less attention has been given to the ways in which the founding of hospitals was intertwined with domestic traditions and the practical challenges inherent in their implementation. By examining the establishment of the Seraphim Hospital in Stockholm, along with subsequent hospital foundations in Sweden, the practical difficulties involved become evident. Some of these challenges, particularly those related to funding difficulties, bear a striking resemblance to contemporary discussions on enhancing the efficiency of healthcare, despite the differing historical contexts. In the Swedish eighteenth-century context, ecclesiastical authority in medical matters persisted and played a role in the establishment process, while the military character of the kingdom also influenced hospital development. The conclusion drawn is that both national and local conditions shaped how medical reforms were conceived and practised. The historiographical emphasis on novelty and change may, at times, obscure the continuity of past practices, which undeniably played a crucial role in shaping the new. The concept of path dependency is thus employed not only to trace these historical connections but also to explore the ways in which they influenced the Swedish context, ultimately shaping the trajectory of hospital development in the country.

The best known historical narrative of the international mental hygiene movement among English-speaking audiences locates its origins in the publication of A Mind That Found Itself, the autobiographical account of Clifford Beers (1876–1943), a Yale graduate and former psychiatric patient. The success of the book is thought to have prompted the creation of the first Society for Mental Hygiene in Connecticut in 1908. Beers’ biography, published as Advocate for the Insane in 1980, contends that mental hygiene abroad developed from seeds first sown in the USA and subsequently in Canada.

This article offers a critical reappraisal of that narrative and advances an alternative framework for understanding the history of the international mental hygiene movement during the first half of the twentieth century. It draws on a body of scholarship, emerging since the 1980s, that has sought to decentre the prevailing account, exposing the multiplicity of forces at work in a history that diverges from any straightforward, linear trajectory radiating from a single point of origin.

By tracing this decentred history, the article highlights the contested nature of the ‘international’ in the context of the mental hygiene movement. Case studies from the USA, France, Brazil, and Argentina reveal both the conflicts it engendered and the diverse meanings and significance it assumed within distinct national settings.

The 1896 Bombay plague outbreak prompted the colonial government to recruit trained British nurses from England to serve the afflicted Indians of the Presidency. Studying this relatively under-explored aspect of British colonial nursing, this paper examines the politics of representation of the Western, non-military nurses serving the colonised Other through nineteenth-century periodical accounts and personal letters of a nurse stationed in Bombay. Owing to the popularity of British periodicals and the significant role they played in shaping public debates in the Metropole, periodical plague literature portrayed Western nurses as spokespersons for the Empire’s benevolent rule in Bombay. Contrarily, the intimacy and confidentiality of letter-writing allowed nurses to offer a more nuanced and critical account of life and work in Bombay. The paper contends that the non-military Western nurse’s medical career, mobility, and financial stability framed her multidimensional identity, which was further defined by the intersecting issues of race, class, gender and culture she encountered in Bombay. Comparing their varied portrayals in the periodicals and the letters, the paper argues that the politics of representation of women’s lives were influenced by both their sociopolitical subjectivities and the narrative forms through which they articulated their experiences.

The inter-war period was a time of mobilisation against syphilis in France and its colonial empire. The spread of the disease was perceived as a threat to the economic development of its colonies, particularly because of the labour shortages it might cause. In 1916, a new player appeared on the scene of the French efforts to control the disease: the Institut Prophylactique, founded by Arthur Vernes. Its project was nothing less than to eradicate the disease, and its activities in the colonies expanded significantly during the 1920s and 1930s. However, the Institut Prophylactique has been largely forgotten in the history of medicine. Although the project was a failure, this article shows that it played an important role in controlling syphilis, both in France and in its colonies. This historical study thus emphasises the importance of considering alternative and failed projects as part of the complex picture of health history.

Examining the systemic exploitation of mentally ill individuals, this study focuses on the practices of the British colonial administration in Kabba Province, Northern Nigeria (1900–1947). This research investigates how colonial authorities employed biopolitical strategies to categorise, control, and exploit this vulnerable population for labour, prioritising colonial economic and administrative interests. The study utilises a qualitative methodology, primarily analysing archival documents from the National Archives of Nigeria (NAK), Kaduna, and Arewa House Archives (AHA), to uncover the forced labour system’s practices and rationalisations. Crucially, it incorporates oral sources from direct descendants of ethno-medical practitioners, former colonial staff, traditional chiefs, and learned community members. This oral history component provides vital intergenerational knowledge, contextualising archival findings and offering perspectives often absent from official records, ensuring a nuanced understanding of pre-colonial mental health practices and colonial-era lived experiences. Secondary literature on colonial biopower, mental health history, and regional history provides a comparative framework. Findings indicate the colonial administration systematically repurposed traditional care and established new mechanisms to identify, isolate, and compel mentally ill individuals into various forms of forced labour for infrastructure and economic extraction. In conclusion, this research significantly contributes to scholarship on vulnerable populations during colonialism, illuminating the intricate link between mental illness, labour, and power in colonial Nigeria, and informing contemporary debates on mental health, human rights, and historical justice.

Literature about the discovery of the leprosy bacterium Mycobacterium leprae usually mentions the Hansen-Neisser controversy. It is an established narrative that Neisser tried to present himself as the discoverer of the leprosy bacterium. However, Neisser’s first publication on Mycobacterium leprae refers explicitly to Hansen’s original discovery. How did the notion of Neisser trying to claim Hansen’s discovery emerge? A thorough source-critical examination of Hansen’s and Neisser’s scientific and popular publications between 1874 and 1897 as well as of the literature dealing with the so-called controversy brought interesting new results. The notion that Neisser tried to steal Hansen’s discovery is based on a misreading of Neisser’s publications by Hansen’s biographer. But Neisser tried indeed to bypass Hansen in trying to prove that Mycobacterium leprae was the contagion causing leprosy. The competition between the two scientists resulted in a personal enmity. This study shows how the history of modern science is prone to myths and underlines the importance of source criticism when dealing with established narratives.

This article examines the historical transformation of childhood vaccination in the Netherlands between 1872 and 1959. It analyses how vaccination was reframed from an individual parental responsibility to a collective practice through the establishment of the ‘Rijksvaccinatieprogramma’ (National Immunisation Programme). I analyse this historical trajectory as a case of ‘public health atomism’, a strategy that achieves collective health by prioritizing individual health outcomes and local action. Rather than relying on top-down state mandates, the ‘Rijksvaccinatieprogramma’ was a consequence of co-operation between general practitioners, municipal health officials, civil society organisations, and volunteers. Drawing from published medical sources, parliamentary records, and material from local and national archives, this article provides a detailed historical account of how local governance and autonomy shaped vaccination practices, highlighting the role of the ‘entgemeenschap’ (vaccination community) as a key organisational model for situated collaboration. As such, it revisits childhood vaccination as an archetypical example of biopolitical state intervention, demonstrating how localised, flexible co-operation was instrumental in integrating vaccination into Dutch society.

This article analyzes the medicalisation strategies deployed by Peruvian alienists in the daily life of the Lima Asylum during the last third of the 19th century. Special attention is given to the process of hospitalisation of the insane in the psychiatric hospital, since this administrative procedure reveals the dialogue, confrontation, and negotiation between the asylum staff and the state and social bodies in the public management of insanity. Through the support of the civil authorities in charge of the psychiatric hospital administration, we argued that the local alienists sought to impose medical knowledge in the asylum space as the legitimate criterion for the confinement of the insane in Peru. This process was not without tensions, setbacks, and disputes, especially with the families and the state agencies of control and social defence seeking to preserve their former prerogatives over the fate of their insane. However, we propose that these medicalisation strategies promoted by the alienists in the daily space of the Lima Asylum managed to situate psychiatric care as a state problem and these actors as experts in the public management of insanity.

Developments such as the opening of the first psychiatric outpatient clinic, the emergence of psychiatric social work, the surge of interest in psychology and psychiatry, and the tightening of notions about sexual hygiene, intersected with the rise of the mental hygiene movement in India from 1930s. There exists little to no discussion on how mental hygiene developed in the colonies. This study is the first to shed light on the lesser-known chapter of psychiatry in India. The dynamics of family, childhood, and nation-state when merged with ideas about racism, caste, and communalism were critical in the making of new nation-states like India. Moreover, the trajectory of India’s participation in international health movements, such as psychoanalysis and mental hygiene, allowed for exchange and participation. India’s participation in the mental hygiene movement allowed the growth of psy-disciplines in innumerable ways. This paper fills in a major lacuna in historical writing by providing an outline of the number of interconnected developments in the colonies, which are often sidelined. The international visibility of India also permitted India to take centre stage in many significant studies that were conducted by the World Health Organization after the Second World War.

This article assesses the impact of the discovery of bacteriophages, which emerged from an investigation into a 1915 outbreak of bacillary dysentery in France, on influenza virus research. Specifically, it details the way in which the phages became a vehicle for importing certain assay techniques into the study of influenza and other viruses that cause infectious diseases in humans and other animals, thereby enabling the scaling up of vaccine production for these diseases. Very soon after his 1917 report of the discovery of bacteriophages, Felix d’Herelle developed an assay technique based on their ability to form countable plaques on solid media when incubated along with the dysentery bacteria. This basic technique was further refined by Macfarlane Burnet in the late 1920s. Still later, in the wake of a 1935 influenza outbreak in Australia, Burnet applied the principles of serial dilution and plaque counting, honed during his work on the phages, to develop a technique for cultivating influenza viruses in fertilised eggs and assaying them by counting the pocks induced on the chick embryo membranes. The ability to grow and assay these viruses proved crucial in developing the first successful vaccines against influenza. In the 1950s, bacteriophage assay techniques were once more carried over to the assaying of viruses on cultured cells by Renato Dulbecco and Marguerite Vogt. The importance of quantification in science, as well as the ability to apply the results of investigations in one area of biology to another, relatively unrelated field, is also discussed.

This article is an attempt to reconstruct the history of the first Nigerien psychiatric service, and diverse aspects of the ordinary functioning of Pavillon E in Niamey (Niger): the organisation of daily life, the position occupied by coopérant doctors, the precise perimeter and development of practices taken from social and community psychiatry, and relationships with the outside world (families, police, legal system, the public health office).

This research allows us to rehistoricise and refine the details of a period from 1950 to 1980 which, up until now, was viewed as fixed and anachronistic. We draw on precious sources of empirical data – medical and administrative archives, students’ dissertations, oral sources – which invite us to reconsider both colonial/post-colonial (dis)continuities and the temporal caesuras in the literature or in reports from the time.

This landscape of mental healthcare appears to be more or less deeply affected by regional and international dynamics, such as the French coopération system, the networks of ethnopsychiatry and transcultural psychiatry, or the network of pharmaceutical groups and their subsidiaries.

Studying this service also raises the issues of the chronology and daily life of post-independence psychiatric care in francophone West Africa. Finally, our research interrogates the intellectual partitions between reforming disalienist movements and day-to-day psychiatry, and addresses fundamental epistemological questions on how historiography can restore the balance of knowledge between them.

The closed method for the treatment of compound fractures of the limbs emerged and popularised during the interwar period. The historiography on this procedure sustains an essentially Anglo-Saxon narrative focusing on contributions by the American surgeon Winnett H. Orr during the First World War and the Spanish Josep Trueta during the Spanish Civil War and his exile in Britain. This paper aims to ‘open’ this story by reconstructing the early work of another Spanish surgeon: Manuel Bastos. Although originally an army medical officer, Bastos specialised in the treatment of limb fractures in a dual military-civilian context. On the one hand, during successive assignments to the Spanish Protectorate in Morocco, he familiarised with the management of gunshot wounds. On the other hand, he specialised in the treatment of tuberculosis humerus fractures in children at the Instituto Rubio in Madrid. The visit to Spain of the Argentinian surgeon Pedro Chutró, who had acquired a great prestige in First World War Paris for his approach to fractures and osteomyelitis, and the escalation of the Moroccan campaigns to the so-called Rif War (1921–27) gave Bastos the opportunity, the idea, and the courage to develop a closed treatment of humerus fractures in soldiers. Chutró’s influence on Bastos persisted in the context of the Hispano-Americanist policy embraced in mid-twentieth-century Spain. Ultimately, this study questions the understanding of the closed method as a single, univocally traceable procedure, suggesting instead parallel versions emerging in different sites and transforming themselves and influencing each other as they circulated globally.

The U.S. National Library of Medicine holds two collections by Adolf Nichtenhauser (1903–53) that have become important sources for historians of medical and health films: an unpublished book-manuscript in which he surveys the history of medical and health films to around 1950, primarily in Europe and North America; and the valuable collection of documents he amassed partly during his research for this book-manuscript. Such is the richness of these collections that it is difficult to imagine a history of medical and health film that is not in some way indebted to Nichtenhauser. Indeed, his book-manuscript has become a standard citation in the historiography of medicine, health and film. Yet very little is known about Nichtenhauser himself, other than that he was a European immigrant to the United States who wrote this key history and died before its completion. This article seeks to do three things: to provide the first English-language biography of Nichtenhauser from his early life in Austria to his career in the United States; to use this biography to explain how he came to write this book-manuscript; and to explore the relationship between his historiography and efforts in the 1940s and 1950s to identify and solve problems with application of film to medicine and health.

The Spanish influenza pandemic of 1918 caused well over fifty million deaths. The epicentre undoubtedly was China, where gene mixing of different virus strains occurred amongst aquatic, migrant birds. But where and when did the virus first infect (or spill over to) a human being? We take, as our starting point, a paper demonstrating that an infection causing the same symptoms as the influenza virus was widespread in New York during the winter of 1917–1918. The authors of that paper went on to suggest that the virus had probably reached North America from Europe, in the context of troop movement during World War I. Our own researches have focussed on this point. We show that outbreaks of serious respiratory disease, local in nature but causing unusual patterns of mortality, were indeed reported by scientists and doctors in army hospitals in England and in France, well before the first wave of the pandemic had arrived. We use the records of these hospitals, now held in the National Archives, to trace the progress of this disease amongst the individuals who fell ill. We examine contemporary reactions to this minor epidemic – an epidemic, we suggest, which acted as a herald wave of the pandemic yet to come. The latter part of our paper addresses the second question, as to how troop movement across the North Atlantic, once the United States had entered into war, may well have enabled the virus to spread from Europe to North America.

The Pinel Sanatorium, the brainchild of Doctor Antonio Carlos Pacheco e Silva, a leading figure in Brazilian psychiatry, was inaugurated in 1929 in São Paulo as a private institution. It operated until 1944, during which time it recorded approximately 4,500 hospitalisations. In 30 psychiatric records, in addition to the usual clinical records, such as the Psychiatric Examination – in which the doctor records the elements he deems essential for identifying the mental illness from different sources of information, such as those provided by family members – attachments were found containing letters and short texts written by the inpatients. Addressed to different people, these letters, which were retained and evaluated by the doctors, played a central role in assessing the psychiatric conditions of the inmates. However, by being considered historical sources that reveal the ‘point of view’ of the mad, these documents are fundamental to the development of innovative approaches in the field of the history of madness and psychiatry. Based on the articulation between the context in which these records were produced, the social markers of difference that constitute the subjects, as well as the emotions expressed by the people who wrote them, the article sets out to answer two questions: (1) How the emotions expressed – both by the inmates and by their loved ones – were interpreted by psychiatrists and used to formulate diagnoses, and to define treatments and prognoses; (2) What meanings these emotions took on for the inmates themselves, in other words, how they put their experiences and subjectivities on display.

This paper examines letters from the casebooks of the Valkenberg Lunatic Asylum in the Cape Colony during the South African War. Valkenberg was opened in 1891 in Cape Town, and was the only asylum established exclusively for white patients in the Cape. The South African War took place between 1899 and 1902, and several soldiers serving in the War were treated at Valkenberg during this period. The letters were written by a male patient who used bureaucratic and legal channels to claim his sanity and secure release from the asylum, showcasing a rare example from the archive of a patient’s voice as well as a view into the inner workings of a colonial asylum in South Africa. These letters allow a view into the personal lives of patients and attendants, the medical rules doctors followed, and instances of racism, unexpected solidarity, and loneliness. Analysing these letters reveals the changes taking place in a turbulent South Africa, including the tensions and conflicts of a country at war, the racism and nationalism of early twentieth-century South Africa, and the violence present within the asylum network. By examining letters written directly by a patient, which give voice to a perspective that official institutional records would not ordinarily allow, this paper seeks to contribute to the literature on patient voices in the history of psychiatry.

In this article we trace a biography of vacuum aspiration in Spain between the 1960s and 1980s. Analysing the local but transnationally connected history of vacuum aspiration during late Francoism and the democratic transition, we argue that this technology was since the mid-1960s reincarnated in mainstream medical discourse as vacuum curettage, presented as a major medical innovation in diagnosis and therapy. While abortion activists working at the end of the 1970s emphasized the group and political components of a technique they called the ‘Karman method’, doctors performing illegal abortions within the family planning network defined vacuum aspiration in terms of safety and medical innovation. As we demonstrate, this technique embodied meanings that at times overlapped, at others conflicted, contingent on whether aspirations were linked to medical innovation, pro-abortion activism, or social justice.