Since antiquity, some men have not been considered accountable for their actions when they transgressed the law, and were exempted from legal penalties, or given lesser ones. Why? The rationale for legal exemption has varied over time. So have the labels assigned to such lawbreakers, and even the personnel involved in the labelling process. For centuries, settling the question of deviant mental states of relevance to the court seemed relatively unproblematic. It was thought that personal acquaintance would easily discover such states of mind and the court could then be notified. It was not until the nineteenth century that western society felt a need to regulate this problematique. As a result, or as a precondition for this process of settling the question of legal accountability, the matter came to be construed in part as a medical problem. Physicians, and later psychiatrists, came to be regarded as possessing specific knowledge in this area which qualified them to judge a person's legal accountability. Personal knowledge of the deranged defendant was supplanted by professional knowledge of sanity and insanity as the basis for authority on the matter of accountability.

This paper introduces simulation-based re-enactment (SBR) as a novel method of documenting and studying the recent history of surgical practice. SBR aims to capture ways of surgical working that remain within living memory but have been superseded due to technical advances and changes in working patterns. Inspired by broader efforts in historical re-enactment and the use of simulation within surgical education, SBR seeks to overcome some of the weaknesses associated with text-based, surgeon-centred approaches to the history of surgery. The paper describes how we applied SBR to a previously common operation that is now rarely performed due to the introduction of keyhole surgery: open cholecystectomy or removal of the gall bladder. Key aspects of a 1980s operating theatre were recreated, and retired surgical teams (comprising surgeon, anaesthetist and theatre nurse) invited to re-enact, and educate surgical trainees in this procedure. Video recording, supplemented by pre- and post-re-enactment interviews, enabled the teams’ conduct of this operation to be placed on the historical record. These recordings were then used to derive insights into the social and technical nature of surgical expertise, its distribution throughout the surgical team, and the members’ tacit and frequently sub-conscious ways of working. While acknowledging some of the limitations of SBR, we argue that its utility to historians – as well as surgeons – merits its more extensive application.

This paper attempts a comprehensive account of ‘fibre medicine’ elaborated by iatromechanists from c. 1700 to c. 1740. Fibre medicine, a medical theory informed by the notion of the fibre, has been neglected by medical historians despite the pivotal role played by the fibre in animal economy. Referring to a wide range of medical fields such as anatomy, physiology, pathology, therapeutics and life sciences, this paper elucidates the ways that the fibre serves as an indispensable concept for iatromechanists to establish their medical theories. This paper also highlights the metaphorical dimension of the fibre as an integral part of fibre medicine. In re-evaluating the concept of the fibre, this paper seeks to redress the neuro-centric view of eighteenth-century medicine, and attempts to locate the fibre body amidst the fundamental shift from humoralism to solidism.

The birth of Louise Brown, the world’s first ‘test-tube baby’, has come to signify the moment at which technologically assisted human reproduction became a re ality. This was a highly mediated and visible reality, as this article explores through the example of a British television documentary about Louise Brown broadcast when she was just six weeks old, ‘To Mrs Brown… A Daughter’ (Thames Television, 1978). In the article, I discuss the programme alongside data from an interview with its producer, Peter Williams. Williams sought to convince the public that IVF was morally acceptable and to cultivate sympathy for the infertile through this film. I will consider how he went about this by focusing on the programme’s visual presentation of Louise Brown, Peter Williams’ aims in making the film and his sympathetic relationship with the ‘pioneers’ of IVF, gynaecologist Patrick Steptoe and physiologist Robert Edwards. I will conclude with a discussion of the political implications of this film and how it contributed to the normalisation of IVF at a pivotal moment in its history.

Based on a wide range of primary materials, including WHO reports and Colonial Office correspondence, this article examines the UNICEF/WHO-funded mass BCG campaigns that were carried out in seven Caribbean colonies between 1951 and 1956. It explores the reasons behind them, their nature and aftermath and also compares them to those in other non-European countries and discusses them within a context of decolonisation. In doing so, it not only adds to the scholarship on TB in non-European contexts, which had tended to focus on Africa and Asia, but also to the relatively new field of Caribbean medical history and the rapidly expanding body of work on international health, which has paid scant attention to the Anglophone Caribbean and the pre-independence period.