The late eighteenth and early nineteenth century witnessed a dramatic increase in the number of pauper lunatics being admitted to institutions and many mentally-ill paupers found their way into workhouses. The range of options existing for the admission of paupers, who at the time were described as lunatics or insane, included private madhouses, charitable asylums, public asylums as well as workhouses. Legislation relating to transfer from a workhouse to a one of these other institutions was ambiguous and depended on the concept of dangerousness and whether a workhouse inmate was manageable, rather than the nature of their illness. Because demand exceeded the space available because of overcrowding, workhouses and public asylums continually needed to increase provision by means of converting existing facilities or erecting new buildings. Nevertheless, the transfer of patients between asylums was commonplace and extensive. This article will explore the interface between two urban workhouses in the West Midlands of England and their local asylums from the late eighteenth until the end of the nineteenth century. It will demonstrate that, although local circumstances at any one time may have contributed to decisions on transfer, the overriding difficulty in the correct placement of pauper lunatics throughout the time period was institutional overcrowding, mainly driven by the increasing numbers of pauper lunatics.

Nineteenth-century physicians increasingly favoured leeching – the placing of a live leech onto a patient’s skin to stimulate or limit blood flow – as a cure for numerous ailments. As conviction in their therapeutic properties spread, leech therapy dominated European medicine; France imported over fifty million leeches in one year. Demand soon outpaced supply, spawning a lucrative global trade. Over-collection and farming eventually destroyed leech habitats, wreaked environmental havoc and forced European merchants to seek new supply sources. Vast colonies of leeches were found to inhabit the immense wetlands of the Ottoman Empire, which soon became a major exporter of medicinal leeches. Following the Treaty of Balta Liman (1838), the Ottoman state moved to exert control over the lucrative trade, imposing a tax on leech gathering and contracting with tax-farmers (mültezim) to collect the taxes. British diplomats, merchants and other stakeholders protested the imposition of the tax, as had previously happened with the commodification of wildlife; their pursuit of profit led collectors and farmers to over-gather leeches, with catastrophic consequences. By the end of the century, so great had their worth climbed that the leech population faced extinction. This paper situates medicinal leeches as therapeutic actors of history and adopts an interscale approach in formulating the human-leech interaction. It offers a substantive contribution to the history of medicine, in revealing the centrality of leeches to the rise of modern medicine and global trade, but also by making visible their role in shaping imperial diplomacy and worldwide economic markets.

The theory that the people of the early modern period slept in well-defined segments of ‘first’ and ‘second’ sleeps has been highly influential in both scholarly literature and mainstream media over the past twenty years. Based on a combination of scientific, anthropological and textual evidence, the segmented sleep theory has been used to illuminate discussions regarding important aspects of early modern nocturnal culture; mainstream media reports, meanwhile, have proposed segmented sleep as a potentially ‘natural’ and healthier alternative to consolidated blocks of sleep. In this article, I re-examine the scientific, anthropological and early modern literary sources behind the segmented sleep theory and ask if the evidence might support other models of early modern sleep that are not characterised by segmentation, while acknowledging that construction of such models is by nature limited and uncertain. I propose a more diverse range of interpretations of early modern texts related to sleep, with important implications for medical and social history and literary scholarship.

The essays in this forum demonstrate how attending to the intricacies of documentary practice provides a way to see legal practices over the long haul. Different materials—for instance, paper and palm leaves—manifested different ways of understanding and doing law. But change from one way of doing law to another is sticky; old practices persist alongside new ones. Appreciating this helps us see past apparent ruptures in ways of living brought about by states and empires as they come and go. By looking closely at the routines and physical materials through which law works, we can look past simple binaries: European vs. indigenous; pre-colonial vs. colonial; resistance vs. accommodation; oral vs. literate; manuscript vs. print; paper vs. palm leaf.

The fear of the malingering soldier or veteran has existed in Australia since its first nationwide military venture in South Africa. The establishment of the Repatriation Department in 1917 saw the medical, military and political fields work collectively, to some extent, to support hundreds of thousands of men who returned from their military service wounded or ill. Over the next decades the medical profession occasionally criticised the Repatriation Department’s alleged laxness towards soldier recipients of military pensions, particularly those with less visible war-related psychiatric conditions. In 1963 this reached a crescendo when a group of Australian doctors drew battle lines in the correspondence pages of the Medical Journal of Australia, accusing the Repatriation Department of directing a ‘national scandal’, and provoking responses by both the Minister for Repatriation and the Chairman of the War Pensions Assessment Appeal Tribunal. Although this controversy and its aftermath does allow for closer investigation of the inner workings of the Repatriation Department, the words of the doctors themselves about ‘phony cronies’, ‘deadbeats’ and ‘drongoes’ also reveal how the medical fear of the malingering soldier, and particularly the traumatised soldier-malingerer, lingered into the early 1960s and beyond. This paper will analyse the medical conceptualisation of the traumatised soldier in the 1960s in relation to historical conceptions of malingering, the increasingly tenuous position of psychiatry, as well as the socio-medical ‘sick role’, and will explore possible links with the current soldier and veteran suicide crisis in Australia.

Anthropologists and historians have recently underscored the ways in which European colonialism created novel regimes of legality and record-keeping, associated with ambitious and exclusive state-centered claims to both truth and rights, while being inevitably and constantly sucked into eddies of forgery and corruption. However, attention so far has been focused on English/European-language records and the colonial institutions that produced, stored, and deployed them. This has communicated a monolithic sense of power and normativity that unwittingly replicates the aspirations of colonial states. Drawing on eight case studies from in and around South Asia from the eighteenth to the twentieth centuries, we propose instead that the law of empires was rooted in the highly localized, often multilingual, and fragmented bureaucracies that produced its records. Here, historians of pre-colonial Indian regimes join hands with historians of British, Dutch, and French colonialism in order to unearth the genealogies of records written in Bengali, Marathi, Persian, Sinhala, and Tamil, as well as in French, Dutch, and English. This special issue collectively excavates the many layers, regimes, and languages in which legally effective records were produced by imperial regimes in South Asia and its much larger watery penumbra, the Indian Ocean.

Guinea worm disease (dracunculiasis) is a debilitating waterborne disease. Once widespread, it is now on the brink of eradication. However, the Guinea Worm Eradication Programme (GWEP), like guinea worm itself, has been under-studied by historians. The GWEP demonstrates an unusual model of eradication, one focused on primary healthcare (PHC), community participation, health education and behavioural change (safe drinking). The PHC movement collided with a waterborne disease, which required rapid but straightforward treatment to prevent transmission, creating a historical space for the emergence of village-based volunteer health workers, as local actors realigned global health policy on a local level. These Village Volunteers placed eradication in the hands of residents of endemic areas, epitomising the participation-focused nature of the GWEP. This participatory mode of eradication highlights the agency of those in endemic areas, who, through volunteering, safe drinking and community self-help, have been the driving force behind dracunculiasis eradication. In the twenty-first century, guinea worm has become firstly a problem of human mobility, as global health has struggled to contain cases in refugees and nomads, and latterly a zoonotic disease, as guinea worm has shifted hosts to become primarily a parasite of dogs. This demonstrates both the potential of One Health approaches and the need for One Health to adopt from PHC and the GWEP a focus on the health of humans and animals in isolated and impoverished areas. Guinea worm demonstrates how the biological and the historical interact, with the GWEP and guinea worm shaping each other over the course of the eradication programme.

How has American Catholicism interacted with American legal culture? Legal scholars have often examined this question in the context of contraception and abortion debates. This article focuses instead on the so-called Catholic left that emerged in protest against the Vietnam War in the late 1960s, and thereby seeks to bring the rich history of Catholic radicalism and peace activism into closer conversation with legal history. Drawing on both primary sources and a rich body of secondary literature in religious and social history that legal scholarship has not fully incorporated, the author examines ideas about law within the writings of Catholic left figures, including writer-monk Thomas Merton, sociologist-priest Paul Hanly Furfey, and activist-priest Berrigan brothers. Building on work by religious historians who have interpreted the Catholic radical tradition as a distinctive response to the limitations of political liberalism, this author emphasizes that the Catholic left also expressed a profound alienation from legal liberalism, with its veneration of lawyers and its faith in courts as sites of social progress. Revisiting the Catholic left through the lens of legal history raises questions for future research about the possible connections between leftist antiliberalism and the more familiar Catholic tradition of conservative illiberalism.

The question that this paper tries to answer is Q: “Can good academic bioethics be done without commitment to moral theory?” It is argued that the answer to Q is an unequivocal “Yes” for most of what we could call “critical bioethics,” that is, the kind of bioethics work that primarily criticizes positions or arguments already in the literature or put forward by policymakers. The answer is also “Yes” for much of empirical bioethics. The second part of the paper then provides an analysis of Q in relation to “constructive bioethics,” that is, bioethics work aimed at providing an argument for a particular position. In this part, it is argued that a number of the approaches or methods used that initially look like they involve no commitment to moral theory, nevertheless, involve such a commitment. This is shown to be the case for reflective equilibrium, mid-level theory, the use of theory fragments, and argument by analogy.

Since its introduction in 1964, the World Medical Association’s Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects has enshrined the importance of safeguarding the well-being of human subjects in clinical research. The Declaration has undergone seven revisions, often in response to requests for clarification. I want to argue that the Declaration is in need of another revision in light of recent discoveries in placebo research.

In contrast to the well-studied shopkeepers, little empirical evidence exists on the locational patterns of artisans in transforming urban spaces. By GIS mapping a dataset on Brussels construction entrepreneurs (c. 1830–1930), long-term changes in their patterns of spatial clustering and dispersal become clear, showing which urban areas provided advantageous conditions for artisans to thrive, but also how and when these conditions subsided. While confirming earlier observations of a broad scattering of artisans throughout the city, the analysis also shows how remarkable clusters emerged in cheap, densely built, both central and suburban neighbourhoods. The importance of clustering decreased over time, however. Confronting locational patterns with their potential underlying causes shows that planning policies for the renewal of urban infrastructure and the resulting dynamics on the real estate market acted as the first drivers of urban de-industrialization, affecting the displacement of artisans from inner cities since at least the late nineteenth century.

The complexity of the human brain creates a spectrum of sophisticated behavioral repertoires, such as language, tool use, self-awareness, symbolic thought, cultural learning, and consciousness. Understanding how the human brain achieves that has been a longstanding challenge for neuroscientists and may bring insights into the evolution of human cognition and disease states. Human pluripotent stem cells could differentiate into specialized cell types and tissues in vitro. From this pluripotent state, it is possible to generate models of the human brain, such as brain organoids. The recent observation that brain organoids can spontaneously develop complex neural network activity in a dish can help one understand how neural network oscillations evolve and vary between normal and disease states. Moreover, this finding can be leveraged to other applications outside medicine, including engineering and artificial intelligence. However, as the brain model technology becomes more complex, it raises a series of ethical and moral dilemmas. This article discusses the status of this technology, some of its current limitations, and a vision of the future.