In August, 1880, George Murray Humphry, in his presidential address to the British Medical Association (BMA), called for “collective action” by the country's “eight thousand physicians” to accumulate observations concerning the role of “temperamental, climacteric, and topographical agencies upon disease”. Through participating in organized inquiries, practitioners would “deepen their interest in the science of medicine, and impart the charm of wider usefulness to the daily routine of life”. By December 1881, the BMA had funded a Collective Investigation Committee, which over the next eight years would sponsor nearly a dozen inquiries into the natural history of disease. Beyond Great Britain, Humphry's appeal would launch an international movement for collective investigation, with physicians in Germany, the Netherlands, Norway, Sweden, and the United States following the British example.

In 1856 a Parisian physician called Auguste Delpech presented a paper to the French Academy of Medicine in which he described the strange behaviour of workers employed in the production of India rubber. Many of these men, Delpech reported, had symptoms of mental derangement resembling acute alcohol intoxication. They suffered from impaired memory, vague and confused thoughts, restlessness and insomnia. In particular, they exhibited changeable moods of hilarity and manic outbursts followed by drowsiness, apathy and inertia. The source of the problem, accurately identified by Delpech, was the inhalation of large quantities of a highly neurotoxic compound called carbon disulphide. This was used to soften and spread the latex gum in order to produce rubber sheets. Early rubber making was largely a cottage industry, carried out in poorly ventilated workrooms. With the expansion of the industry into larger scale production during the second half of the nineteenth century, further reports of “insanity” associated with rubber manufacture began to appear in the medical literature. In 1902, the physician Thomas Oliver, reporting on the British Committee on Dangerous Trades of 1899, described episodes during the manufacture of mackintoshes in which workers suffered from “an extremely violent maniacal condition whereby, in their frenzy, [they] have precipitated themselves from the top rooms of the factory to the ground”. It was further observed that the windows of rubber vulcanizing rooms were frequently barred as a preventive measure.

Over the last three decades, Norway has experienced two fundamental reforms in hospital organization and direction. In 1970 the nineteen county authorities took over ownership and budget responsibilities for hospitals within their areas, replacing a highly varied and complex structure of ownership, typically generated locally. In 2002 hospitals were transferred to the state and amalgamated into five regional government enterprises. These, in turn, have organized all hospitals in their region under local health enterprises. Both regional and local enterprises are separate legal entities, with their own executive boards and managing directors. The Minister of Health appoints the boards of the regional enterprises, while their directors and the boards of the local enterprises are appointed by the regional boards. Both regional and local enterprises are supposed to have full autonomy for day-to-day operations, while being subject to strategic and political decisions by the Minister of Health as the ultimate authority of the enterprise assembly (foretaksmøte). The “enterprise” concept is, of course, borrowed from private business, modelled on companies of limited liability. The choice of this organizational model must be understood at least partly within the context of a general politico-administrative reform, inspired by the worldwide New Public Management movement. Each enterprise is a separate economic entity with a clear responsibility for balancing its budgets. Privatization (or part-privatization) and bankruptcy, however, are out of the question, as the state in the end retains full economic responsibility.

During the late nineteenth and early twentieth centuries the development of bacteriology contributed to a heightened focus on the individual as the carrier of contagious diseases. This raised the question of how the state could shoulder the responsibility of defending public health without infringing on individual civil liberties. How much coercion of the diseased could be tolerated in order to protect the healthy? Pandemics such as plague and cholera had sometimes led to enforced isolation of the diseased; people suffering from leprosy might be confined to special institutions, and tuberculosis could result in long stays in hospitals and sanatoria. In such cases, however, it was also hoped that certain treatments might eventually cure the patients.