Organised medicine in a number of advanced industrial countries resisted the post-war trend toward more state involvement in the funding and organisation of medical care. While there were eight doctors’ strikes during the peak of reform efforts in the 1960s, two of the most prolonged and bitter struggles took place in Canada and Belgium. This comparative analysis of the two strikes highlights the philosophy, motives, and strategies of organised medicine in resisting state-led reform efforts. Although historical and institutional contexts in the two countries differed, organised medicine in Canada and Belgium thought and responded in very similar ways to the perceived threat of medical insurance reform. While the perception of who won and who lost the respective doctors’ strikes differed, the ultimate impact on the trajectory of public healthcare on the medical profession was remarkably similar. In both countries, the strike would have a long-standing impact on future reform efforts, particularly efforts to reform physician remuneration in order to facilitate more effective primary healthcare.

This article discusses an under-researched group and provides an analytical overview of the comparative experiences of African, Indian and Coloured doctors at South African universities during the apartheid era. It probes diversity of experience in training and practice as well as gendered differentiation amongst black students before going on to discuss the careers and political activism of black doctors as well as the impact of recent transformational change on their position. It briefly assesses how singular this South African experience was.

This article examines the process by which the London physician Thomas Sydenham (1624–89) rose to fame as the English Hippocrates in the late seventeenth century. It provides a survey of the evidence for the establishment of Sydenham’s reputation from his own writings, his professional relations, and the writings of his supporters and detractors. These sources reveal that in the first decades of his career Sydenham had few supporters and faced much opposition. However, by the end of the seventeenth century, Sydenham was the object of extraordinary outbursts of adulation and had become renowned for his decrying of hypotheses and speculative theory, his promotion of natural histories of disease, and the purported similarities between his medical method and that of Hippocrates. It is argued that Sydenham’s positive reputation owed little to his achievements in medicine: it was almost entirely the result of his promotion by the philosopher John Locke and a small group of sympathetic physicians. It was they who created the English Hippocrates.

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.

Historians of medicine have tended to be preoccupied primarily with scientific research, the development of therapeutically significant medicines, and ethical business practice. Roy Porter, however, adopted a wider conception. Referring to the eighteenth and early nineteenth century, he redefined the role of “the vile race of quacks” (so described by their own contemporaries) as a manifestation of a burgeoning medical entrepreneurship in an emerging consumer society. He maintained that “Irregular medicine … mobilised the growth of medicine as business”, an aspect of medical history which he believed to have been largely ignored hitherto and one which requires of historians an understanding of the market for pharmaceuticals. Anne Digby has examined the market for medical services during the nineteenth century in an analysis of interactions between doctors and patients at a time when self-dosing was prevalent. However, interactions between medical practitioners and suppliers of medicines in Britain for most of this period remain largely unexplored (with the significant exception of the work by Jonathan Liebenau) and as a result, it will be argued, have been misunderstood.

This paper examines how, over the course of the nineteenth and early twentieth centuries, the appreciation of skill in surgery shifted in characteristic ways. Skill is a problematic category in surgery. Its evaluation is embedded into wider cultural expectations and evaluations, which changed over time. The paper examines the discussions about surgical skill in a variety of contexts: the highly competitive environment of celebrity practitioners in the amphitheatres of early nineteenth-century Britain; the science-oriented, technocratic German-language university hospitals later in the century; and the elitist surgeons of late nineteenth and early twentieth-century United States with their concerns about distancing themselves from commercialism and cheap showmanship. For analysing the interaction of surgical practices with their various contexts the paper makes use of the concept of ‘performance’ and examines how the rules of surgical performance varied according to the prevailing technical, social, and moral conditions. Over the course of the century, surgical performance looked more and more recognisably modern, increasingly following the ideals of replicability, universality and standardisation. The changing ideals of surgical skill are a crucial element of the complex history of the emergence of modern surgery, but also an illuminating example of the history of skill in modern medicine.