Chapter 5 begins to draw the reader into the core case studies of the book. The movement of colonial education into the provincial countryside is revealed with a focus on the Puebla-Tlaxcala valley. This helps to build a local-regional component into the theory of learningscapes in An Unholy Pedagogy. Education is shown to be an introduced and foreign system of instruction, though it incorporated indigenous practices from collegians’ influence, and this didactic trajectory bordered the wholistic and preordained expertise of Ibero-Christian systems of learning. Though examining Christian official records, the chapter also seeks local identity and community efforts to navigate regional impacts with the introduced, augmented systems. One core note is that locals participated in the Mesoamerican countryside’s encounter with texts and architects. Against a tragic backdrop, towns established convents via skilled labourers’ hands under the discretion of Indigenous church people. The chapter studies the concept to placemaking in an account of Motolinía, reading against the hagiographic take to note how these active decades of church growth identified local participation and agency in planning developments and using the grounds of new convents and courtyards. A new provincial learningscape takes shape in this portion of the book, with the shining examples drawn from the Indigenous towns of Huexotzinco, Calpan, and Quauhquechollan.

A brief conclusion ties together central themes of the book - deception, blame, and stigma - and reflects on how this history of a long-forgotten epidemic can shed light on everyday life hundreds of years ago in ways that resonate with modern disease experiences.

The first substantive chapter uses a drinking song to tell the story of a man who travels to London from the countryside to attend an annual fair. As he cavorts with a prostitute behind a tent, she picks his pockets and he must leave the city with nothing to show for his time at the fair except a raging case of the pox. The chapter follows the fictional prostitute and the man through the streets, using actual medical cases and advertisements to piece together what each would have felt as their symptoms developed, as well as their desperate attempts to find affordable treatment. The main aim of the chapter is to establish much-needed context for the remainder of the book, both about the disease and about London’s ever-growing market in remedies for it. The chapter shows that those selling pox cures and those selling sex embodied the very same urban threats in writing of the era: in ballads and in medical writing, both prostitutes and purveyors of pox remedies were presumed to be deceptive, self-serving, and sexually aggressive. Their very existence personified the unbridled consumption and unchecked vice of the big city.

This chapter shows how the competitive market for cures outlined in the initial two chapters of the book shaped healers’ self-promotion on the page and negotiations of care in consultation rooms. It begins with a servant maid who allegedly infected the children under her care by sweating near them in a shared bed. A venereal healer took the case, but the maid obstructed his clinical work by repeatedly lying to him. She likely feared for her reputation and her job. Because a diagnosis of venereal disease was deeply shameful, patients like the maid were said to be unreliable narrators. The chapter recovers the intimate details of thirty-two such encounters and how healers brandished their expertise by claiming to navigate the constraints of allegedly dishonest patients. Because patients’ words were so unreliable, they instead turned to obversions of bodies to diagnose disease in ways that foreshadowed clinical practices of the 1800s. And yet, the majority of these cases end with words. Confessions of lurid trysts and scandalous relationships confirmed the existence of unlawful sex, and therefore that cases were venereal, which further validated healers’ diagnostic know-how.

As discussed in Chapter 1, the primary focus of this book is on the potential of neurotechnology to support the rehabilitation of convicted persons by improving risk assessment and risk management – rather than on its potential for diagnosing and treating mental or brain disorders. Still, in some cases, neurorehabilitation might well become conducive or even crucial to the improvement of mental health in forensic populations. Brain stimulation to attenuate aggressive impulses might serve to reduce the mental distress experienced by some persons subject to these impulses. Furthermore, aggression can be a symptom of a recognised mental illness, such as a psychotic disorder, or may be a core feature of a disorder, as in intermittent explosive disorder. Diminishing aggression using neurotechnology could in such cases be relevant to the person’s mental health, which appears to be an interest protected by human rights law. For example, Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) recognises a “right to the highest attainable standard of physical and mental health”.

Galen system is based on three pillars: the affected body part, the type of qualities imbalanced, and the degree of imbalance. Therefore, he only distinguishes between mental illness and impaired consciousness when there is a difference between these two entities in any of these three pillars. Thus, he distinguishes phrenitis from melancholia but not from mania. The emphasis on the system, on the other hand, enables him a very tight notion of disease, where symptoms, mechanisms, affected organ and treatment are closely linked.

Like their forerunners, post-Hellenistic doctors also grappled with the unclear boundaries between healthy versus pathologic sleep, and consciousness-unconsciousness. Furthermore, they incorporated new diseases and redefined others - like lethargy - that were specifically associated with this process. Celsus considered sleep as all-or-nothing phenomenon, without recognising different depths. Regarding mental capacities, he subsumed most of them in his idea of mens/animus. Aretaeus, on the other hand did conceive different depths of sleep, and his eclectic method enabled him to find alternative pathophysiological explanations to characterise several of its main features. Similarly, although his organization of mental capacities varied according to what he was explaining, the opposition gnômê-aisthêsis was important in his idea of mind.

4 Post-Hellenistic authors present a more compartmentalised idea of diseases in general and of impaired consciousness in particular. Unlike the Hippocratics, who barely discussed mental illness, these authors did distinguish impaired consciousness from mental illness through a classificatory system of dichotomic oppositions, additionally they discussed new conditions which are not mentioned in the HC. In most theorisations, perceptions play an increasingly relevant role to understand these conditions.

Some Hippocratic doctors regarded sleep as a healthy process, and some as a pathological one; some of them struggled to distinguish between hallucinations and nightmares, and some between deep dreamless sleep and total loss of consciousness. This chapter explores how different treatises from the Hippocratic corpus navigated these ambiguities, how they explained different depth of sleep (i.e. different levels of consciousness), and how such understanding relates to their views on mental capacities (which they subsumed in concepts such as phronesis, sunesis, gnômê, and nous).

A diachronic look at the contrast between mental illness and impaired consciousness among these ancient doctors shows a trend towards a more compartmentalised idea of these conditions, a stronger notion of disease, and a progressive abstract framing of clinical findings into theoretical classificatory models and comprehensive pathophysiological systems.

Contrary to mainstream scholarship’s opinion, the Hippocratic corpus presents many cases of impaired consciousness, but only a few of mental illness. By looking at three study cases, this chapter describes how these doctors understood conditions where patients act weirdly or were not their usual selves, and how they construed the notion of disease.

In face of the difficulty of establishing clear biological boundaries between sleep and the other forms of impaired consciousness, the sociological and anthropological analyses can provide hints as to where those limits were set in real life. The terminological analysis suggested a common feature that persisted throughout the different authors and periods: different levels of consciousness (from drowsy to hyperactive, and from delirium to koma) where always related to the impairment of mental capacities, regardless of the way in which each medical writer grouped or understood them.

Unlike mental disease, which presupposes a strongly theory-laden concept, impaired consciousness or delirium is currently conceived in medicine as a cluster of symptoms. This chapter contrasts these two constructs, and discusses our current idea about the notion of disease.

Galen conceived sleep and wakefulness as a continuum that depended on the mixture of qualities within the ruling part of the puschê (the hêgemonikon) located in the brain. Naturally, in his system whenever pathological sleep occurred the doctor needed to determine if the brain was affected directly or by sympathy (from another organ), and the precise imbalance of qualities that needed to be counteracted by their opposites. His idea of mind was very accurately and hierarchically structured: it resided in the logical part of the soul, located in the brain, and several diseases with impaired consciousness compromised its normal functioning.

In its opening clause, the preamble to the UN’s Universal Declaration of Human Rights (UDHR) asserts the strong affinity between the concepts of human dignity and human rights. “Recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family,” the declaration grandly begins, “is the foundation of freedom, justice and peace in the world.” Preambles are repositories of lofty rhetoric, but they are also expressions of shared values and basic ideological assumptions. The expansive political claims of the UDHR find justification in the idea of human dignity. Moreover, the Declaration itself helped to cement the place of dignity in the modern discourse of rights, and the importance of dignity as a source of moral justification remains a lively theme in explorations of the origins and normative basis for human rights claims. In the words of Jeremy Waldron, for instance, “Dignity is intimately connected with the idea of rights – as the ground of rights, the content of certain rights, and perhaps even the form and structure of rights.”

This chapter examines the assumptions, concepts, and narratives historians use to study US relations with the natural world: with biological and chemical agents, environmental and physical phenomena, natural resources, and plants, animals, and microbes. Looking beyond the experiences and activities of human beings, it asks how non-human actors and forces can help explain the history of foreign relations. It surveys some of the key medical, scientific, and environmental issues that have shaped the history of foreign policy and international affairs, with an eye toward the methods scholars can employ to analyze these topics most profitably. Although studying these subjects can present methodological challenges, this chapter offers tools and strategies for overcoming those potential roadblocks. Becoming more attuned to medical, scientific, and environmental topics, as the chapter shows, challenges our assumptions about foreign relations in productive ways, offering fresh perspectives on conventional narratives and novel ways of studying the past.