Our contributions examine the Norwegian Karl Evang's (1901-1981) and the Dane Halfdan Mahler's (1923-2016) participation in international health co-operation facilitated by the World Health Organization (WHO) in India in the 1950s. While Evang’s was a hectic, but relatively short visit as part of a WHO visiting team of medical scientists in 1953, Mahler’s spanned the entire decade on assignments as WHO medical officer to tuberculosis control projects. Mahler’s name should be familiar to researchers of international health as the Director-General of the WHO 1973-88, and for his promotion of primary health care through the 1978 Alma-Ata Declaration. Evang, Norway’s Director of Health 1938-72, was also a key figure in international health in the mid-twentieth century as one of the original instigators of the WHO, and a participant in much of its early work.

A core theme is the place of social medicine, both in Evang’s and Mahler’s work, and within the WHO and its navigation of complex postcolonial settings in the 1950s. Investigating cross-regional encounters and circulations of social medicine ideas between Evang and Mahler and their Indian interlocutors as well as international WHO staff members, we ask what the role of social medicine was in international health in the early post-war period. Researchers have found that social medicine had its heyday during the 1930s and 1940s, and that a technology-focused, vertical approach became dominant soon after the war. In contrast, we suggest that continued circulation of social medical ideas points towards a more complicated picture.

Henry Rider Haggard, the famed author of adventure romances, wrote the novel Dr. Therne (1898) in response to weakening compulsory smallpox vaccination laws, thus entering one of the most heated debates of the late nineteenth century. With Dr. Therne, Haggard aimed to intervene in the lives of the many working-class anti-vaccinationists who, from the 1850s onwards, mobilised to evade what they perceived as a gross – and targeted – extension of state power at the expense of individual rights. Recovering the novel, which has not yet received scholarly attention from historians of medicine, reveals the way fiction was called upon to change minds during a crucial period of Victorian medicine, one that witnessed a climactic shift in public health intervention. This article will examine the reception of Dr. Therne in various print media – middle-class London papers, medical journals and working-class, anti-vaccinationist publications – to consider some new dynamics of the debate which the disagreement over Haggard’s polemic exposes, including the perceived power of fiction (when properly priced and distributed) to change minds, and the contested role of the evangelical press. Additionally, a discussion of the different iterations of Dr. Therne, and a look at an exceptional anti-vaccinationist response in the form of a competing novel, illustrates that pro- and anti-vaccinationists alike contributed to a moment in late Victorian society when the role of fiction was considered a worthy contender in a debate ostensibly about fact.

From the last decades of the twentieth century, above all, in the more service-oriented post-industrial economies, and in a context of debilitation of public health systems, health care became exponentially profitable, thereby attracting new types of investors. In fact, this new stage entails moving from the commercialisation of health care to its financialisation; that is, medical care becomes just one more financial asset and its price and quality are quoted on the stock exchange. This study intends to participate in the debate initiated by historians of medicine and economic historians with the aim of tracing capitalist traits and market participation in the evolution of health coverage, a process initially promoted by professional doctors who converted their consulting rooms into small clinics and larger hospital companies and which, over time, saw the incorporation of financial capital. In particular, this paper has two specific objectives for the case of Spain. First, to analyse the relationship of collaboration and/or competition between public and private hospitals under democracy and the factors that have conditioned this relationship. Second, to make an initial contribution towards understanding how, in this context, the large private hospital groups have been created in Spain during this period, especially in recent decades with concentration in the hands of financial capital, originating from both the traditional banking sector and investment funds.

This work examines the history of smallpox, a highly infectious and epidemic disease, in Argentina, throughout different governments and public health policies from the nineteenth to the twentieth century. The study focuses on the smallpox vaccine and the social and collective significance of universal immunization. It also analyses the relationship between governments of different political orientations and the international community regarding the production of vaccines and vaccination campaigns from their implementation to the eradication of the disease.

In the late Soviet period, a great deal of research was conducted on older people’s health, with the Institute of Gerontology Academy of Medical Sciences (AMN) USSR in Kyiv spearheading a great deal of this. Of particular interest was older people’s ability to work beyond retirement age, the issue of premature ageing, as well as physical activity, diet and living conditions. Many of these interests came under the concept of ‘gerohygiene’, which also reflected the Soviet Union’s prophylactic approach to eldercare (and healthcare more generally). Discussions about older people and Soviet research on gerohygiene are important for furthering our understanding of ideas around healthy ageing and the Soviet project more generally. The Soviet, and indeed socialist, research on gerohygiene sheds light on ideas around active ageing, premature ageing and work practices for older people. It also shows that the role of old people belonged to the wider Soviet effort of contributing to the communist project and shaping society. In this article, I define and examine the broad concept of ‘gerohygiene’ and then assess how gerohygiene applied to older people’s health in relation to both physical activity and labour.

In the years 1947–57, following a turbulent retirement, Ugo Cerletti, the father of electroconvulsive therapy (ECT) (1938), invested his energies in a new audacious project conceived as an extension of his ECT research. Forced to leave the direction of the Sapienza University Clinic, he got funds from the National Research Council of Italy to carry out his experimental activities, and founded a ‘Center for the study of the physiopathology of Electro-shock’ in Rome. The Center was aimed at studying liquid substances extracted from electro-shocked animals’ brains that Cerletti named acroagonine and injected into human patients. Inspired by coeval literature, Cerletti believed that electroshock efficacy was due to stimulating some homeostatic processes in the brain, specifically in the meso-diencephalic area (i.e. involving neuroendocrine response in the hypothalamic–pituitary–adrenal axis). Cerletti’s team wished not only to find these effects, but also to reproduce them. With this hypothesis, that proved ineffective, Cerletti anticipated intuitions on the neuroendocrine effects of ECT and the necessity for the development of psychopharmacology. In this article, I cross-combined previously unexplored archival materials stored at Sapienza University of Rome (‘ES Section’) with established bibliographic and archival sources.

This article examines the emergence of modern psychiatric discourse under the culturally Islamic yet radically secular context of the early Turkish republic (1923-1950). To do so, it focuses on the psychiatric publications of Mazhar Osman [Uzman] (1884-1951), the widely acknowledged “father” of modern Turkish psychiatry; and aims to genealogically trace his scientific project of reconceptualizing ruh, an Arabo-Turkish concept that predominantly refers to transcendental soul, rendering it physiologically within the framework of biological-descriptive psychiatry. The article consequently addresses the elusive and multilayered psychiatric language emerged in Turkey as a result of modern psychiatry’s interventions into a field that was previously defined by religion and indigenous traditions. Attempting to contextualize republican psychiatric discourse within the cultural and socio-political circumstances that has produced it, the article sheds light on how the new psychiatric knowledge propagated by Mazhar Osman was formulated in constitutive contradistinction to religious or traditional discourses, explicitly associating them with the Ottoman past and its alleged backwardness, hence reverberating with the Kemalist project of modern Turkish state building. Furthermore, by focusing on the complexities of the Turkish psychiatric language and the contestations it has generated, the article aims to reflect on the ways in which the Turkish psychiatric language was (and presumably still is) haunted by earlier forms of Islamic knowledge and traditions, despite modern psychiatry’s as well as modern secular state’s systematic and authoritative attempts to erase them for good.

Paul-Louis Simond’s 1898 experiment demonstrating fleas as the vector of plague is today recognised as one of the breakthrough moments in modern epidemiology, as it established the insect-borne transmission of plague. Providing the first exhaustive examination of primary sources from the Institut Pasteur’s 1897–98 ‘India Mission’, including Simond’s notebooks, experiment carnets and correspondence, and cross-examining this material with colonial medical sources from the first years of the third plague pandemic in British India, the article demonstrates that Simond’s engagement with the question of the propagation of plague was much more complex and ambiguous than the teleological story reproduced in established historical works suggests. On the one hand, the article reveals that the famous 1898 experiment was botched, and that Simond’s misreported its ambiguous findings for the Annales de l’Institut Pasteur. On the other hand, the article shows that, in the course of his ‘India Mission’, Simond framed rats as involved in the propagation of plague irreducibly in their relation to other potential sources of infection and not simply in terms of a parasitological mechanism. The article illuminates Simond’s complex epidemiological reasoning about plague transmission, situating it within its proper colonial and epistemological context, and argues for a new historical gaze on the rat as an ‘epidemiological dividual’, which highlights the relational and contingent nature of epidemiological framings of the animal during the third plague pandemic.

The St Petersburg declaration, signed in 1868, is a milestone in the history of warfare and humanitarian law, as it prohibits the use of explosive bullets, which are considered to cause unnecessary suffering. As this article shows, the framing of this declaration that put suffering at its centre, as well as the development of the humanitarian movement, favoured the birth of a new field of expertise: wound ballistics. The wars that broke out after the declaration was signed are the subject of intense scrutiny, while the advances in weaponry, and notably, the creation by the British of a new expansive bullet, provided physicians with new fields of investigation. Numerous experiments have attempted to reproduce the effects of bullets on different materials, including corpses. Based on numerous medical reports and publications, as well as military archives from France and the United Kingdom, this investigation critically examines the notion of pain, its assessment and its use in the monitoring of war violence. It argues that, paradoxically, the greater attention paid to suffering has resulted in a need to objectify pain. This rationalisation and the quest for the quantification of suffering have not been without bias and have shifted attention away from care and treatment.

This article examines the introduction of the medical mask in the late nineteenth century at the intersection of surgery, bacteriology and infection control. During this important episode in the longer history of the medical mask, respiratory protection became a tool of targeted germ control. In 1897, the surgeon Johannes Mikulicz at the University of Breslau (now Wroclaw, Poland), drawing on the bacteriological experiments of his colleague Carl Flügge, used a piece of gauze in front of his nose and mouth as a barrier against microorganisms moving from him to his patients. This article explores the social, cultural and medical contexts of this particular use of the mask, in connection with germ theory and surgeons’ struggle with wound infection. It explores the alignment of the new aseptic surgery with the emerging field of bacteriology in a local milieu that favoured interdisciplinary cooperation. The account also follows the uptake of the mask outside of surgery for other anti-infectious purposes and shows how the new type of anti-infectious mask spread simultaneously in operating rooms as well as in hospitals and sanatoria, and eventually in epidemic contexts.

In Japan, schistosomiasis was endemic in Yamanashi Prefecture and a few other hotspot areas where the Miya’iri snail lived. The parasite’s lifecycle relied on the intermediary Miya’iri snail as well as the human host. Parasite eggs passed into the agrarian environment through untreated night soil used as fertiliser or through the culture of open defecation in rural Japan. Manmade rice fields and irrigation ditches, night soil covered paddies and highly refined growing seasons put people in flooded rice paddies to intensively work the land in the spring and summer. The disease was equally dependent on human intervention in the natural world as it was on the natural world intervening in the human body. It is important to stress the role of both the environment and culture in disease causation. This study posits that we view the pre- and post-war national mobilisation to remake the environmental and reform the culture of the rural sector to align with public health mandates and notions of hygienic modernity as a case of total prevention.

Medical acculturation forms a crucial part of the process of migration, and equally, the influx of migrants can shape how medical structures develop in receiving societies – nowhere is that more evident than in the American metropolis. In the late nineteenth century, few ethnic groups caused such sustained bio-hazard concerns as the Irish in America. Poverty and the sheer numbers migrating in the post-Famine (1852-) era, caused the immigrant Irish body to be pathologised, or described in medical terms, to a much greater degree and for longer than their Anglo-Saxon or German counterparts. With a particular focus on Irishwomen’s use of maternity services in New York and Boston, this article aims to elucidate the potential of medical records to flesh out the understandings of how immigrants navigated healthcare. By adopting a case study approach to hospital records in tandem with other data sources, it shows what is being lost through restrictive data protection legislation. It discusses how Irishness was politicised in the contexts of immigration, the social history of medicine and medicalisation.

The Ospedale Maggiore, known as Ca’ Granda, was founded in 1456 by will of Francesco Sforza, Duke of Milan, and was considered for almost five centuries a model for Milanese, Italian and even European healthcare. Attracting patients from all over Europe, the Ca’ Granda distinguished itself for the introduction of new treatments and innovative health reforms. In the burial ground of the hospital still lie the bodies of the deceased patients, who came from the poorest strata of the population. The study of their remains aims to give back a general identity and a story to each of these persons as well as reconstruct a fraction of the sixteenth century population of Milano as concerns lifestyle and disease and examine practises and therapy of this exceptional hospital. It is estimated that about two million commingled bones and articulated skeletons rest in the crypt, together with other types of findings (e.g., ceramic, coins, clothing). These remains are the object of a large project involving various disciplines ranging from humanities to hard sciences. The aim of this paper is to bring this historical gem to the attention of scholars and provide a glimpse of what its contents have already revealed.

The treatment of injured Indian soldiers in Britain during WWI deployed particular ways of recording injuries and using them to make judgments about loyalty to the Imperial Army by assessing the soldier’s ability to malinger. This was possible by using personal correspondences between soldiers and their families for ethnographic ends ie. to determine susceptibility to develop mental illness through a soldier’s ethnic background and whether he was from the so-called ‘martial races’ or not. This classificatory knowledge as well as the suspicion towards exaggerated symptoms was also inherited by Indian psychiatry after partition. However, while these psychiatrists reproduced some colonial biases about susceptibility of illness, they were much more receptive to considering the social experience of patients including their kinship relations at home and in the military. By the end of WWII, symptoms came to be regarded as signs of recovery and readjustment to social relations to make a case for the lasting impacts of war on the soldier’s mental and physical health.

From the mid-nineteenth century, seamen were increasingly identified as vectors of epidemic diseases such as cholera. The rising acceptance of the germ theories of disease and contagion and the transition from sail to steam at this time increased the fear of the rapid spread of contagious diseases through these mobile people. This article examines how the British naval authorities, ship surgeons and the medical and municipal authorities in the Calcutta sailortown sought to improve maritime health and hygiene to prevent the spread of cholera among and by British seamen. Nineteenth century Calcutta is an ideal context for this study on account of its epidemiological notoriety as a disease entrepot and the sea route between Calcutta and British ports was one of the most closely monitored for disease in the Empire. The article argues that a study of cholera among British seamen can generate important insights into the relationship among disease, medicine and colonialism and in doing so shed light into a neglected aspect of the history of nineteenth century cholera, the British anxiety regarding disease dispersion, practice of hygiene and sanitation and British seamen’s health.

During the last decades of colonial rule, Belgian colonial authorities, health agencies and researchers intensely engaged with kwashiorkor, a severe syndrome that was deemed widespread among young children in some parts of the Belgian Congo and Ruanda-Urundi and chiefly attributed to protein malnutrition. To fight kwashiorkor, the Belgian government, in the early 1950s, set up a joint milk distribution campaign with the United Nations International Children’s Emergency Fund, Food and Agriculture Organization and World Health Organization, the first of its kind in colonial Africa. Placing this campaign in the context of mounting international and inter-imperial concern about kwashiorkor and other nutritional problems in Africa and across the globe, this article explores its rationales, mechanisms and consequences, and in particular, how the campaign was shaped and publicised by FORÉAMI, one of the main health providers on the ground. It not only contributes to the history of European colonial medicine and nutritional policies, but also opens new perspectives on international health collaboration during late colonialism. It argues that Belgian authorities were wary of international interference in colonial policies, but that especially FORÉAMI also viewed and used the campaign as an opportunity to display its ‘mastery’ in rural and infant healthcare and control the narrative on Belgium’s colonial medicine.

This article discusses hearing disability in early modern Europe, focusing on medical ideas to demonstrate a profound shift in thinking about deafness over the course of the eighteenth century. Scholars have previously described changes in the social status of the deaf in the eighteenth century, pointing at clerics’ sympathy for the deaf and philosophers’ fascination with gestures as the origin of language, but there is remarkably little scholarship on the growing interest in deafness and hardness of hearing by physicians. From the seventeenth century onwards, however, medical men investigated earwax and mucus in the Eustachian Tube and developed theories about the propagation of sound waves via fluid airs and nervous juices in relation to hearing and deafness. This article argues that this focus on fluids brought about a new medical understanding of auditory perception, which viewed hearing and deafness not as dichotomous but as states along a continuous spectrum. As such, this article offers a new perspective on the study and treatment of hearing difficulties in early modern Europe, arguing that there was no solid dividing line between deafness and hearing; if anything, it was permeable and unstable.

This manuscript investigates clinical decisions and the management of ‘intersex’ children at the University Children’s Hospital Zurich between 1945 and 1970. This was an era of rapid change in paediatric medicine, something that was mirrored in Zurich. Andrea Prader, the principal figure in this paper, started his career during the late 1940s and was instrumental in moving the hospital towards focusing more on expertise in chronic diseases. Starting in 1950, he helped the Zurich hospital to become the premier centre for the treatment of so-called ‘intersex’ children. It is this treatment, and, in particular, the clinical decision-making that is the centre of our article. This field of medicine was itself not stable. Rapid development of diagnostic tools led to the emergence of new diagnostic categories, the availability of new drugs changed the management of the children’s bodies and an increased number of medical experts became involved in decision-making, a particular focus lay with the role of the children themselves and of course with their families. How involved were children or their families in an era widely known as the golden age of medicine?

During the 1960s and 1970s, the notion that the uterus is a useless and pathological organ after a woman has had ‘enough’ children emerged alongside news reports of excessive hysterectomy in Taiwan. This notion and hysterectomy became two sides of the same coin, the former pointing to the burden of birth control and cancer risk, and the latter to sterilization and removing cancer risk. I explore how, in post-war Taiwan, the notion became commonplace through the intersection of three historical formations: the medical tradition of employing surgery to manage risk (such as appendectomy for appendicitis), American-dominated family planning projects that intensified the surgical approach and promoted reproductive rationality, and cancer prevention campaigns that helped cultivate a sense of cancer risk. The gender politics operating in the family planning and cancer prevention projects were apparent. The burden of birth control fell mainly on women, and the cancer prevention campaign, centring almost exclusively on early detection of cervical cancer, made cancer into a woman’s disease. I argue that the discourses of reproductive rationality and disease risk were parallel and, in several key ways, intersecting logics that rendered the uterus useless and pathological and then informed surgeons’ practice of hysterectomy. Exploring the ways in which the uterus was envisioned and targeted in the history of medicine in Taiwan, this paper shows overlapping bio-politics in three strands of research in an East Asian context – namely women’s health, family planning and cancer prevention – and offers a case for global comparison.

From the 1930s, psychiatrists and sociologists documented the prevalence of Irish alcohol-related psychiatric admissions in the United States. These studies seemed to suggest that the Irish, as a race, had a remarkable relationship with drink, therefore reinforcing the enduring ‘drunken Irish’ stereotype. By the 1960s, the alleged Irish susceptibility to alcoholism gained increasing attention from researchers and officials in Ireland itself. Significantly, this renewed awareness coincided with a shift in Ireland’s place on the international landscape and was intertwined with the broader social, cultural and political environment. While anxieties about the apparently rising incidence of alcoholism and alcohol-related harm were not unique to Ireland, the specific cultural meanings attached to excessive drinking in a nation internationally renowned for this problem mapped onto shifting international frameworks, informing medical perceptions and shaping policy developments. This article explores expert and official interpretations of alcoholism and the ‘drunken Irish’ stereotype from 1945 to 1975. This period saw a number of important developments, including the introduction of the Irish Mental Treatment Act of 1945, the establishment of the Irish National Council on Alcoholism in 1966 and the creation of specialist alcohol treatment facilities in several psychiatric hospitals. In the same era, the contexts for understanding problem drinking began to shift from the disease concept of alcoholism towards the public health perspective on alcohol. As will be argued, in Ireland, these frameworks were coloured by concerns that social and cultural factors were contributing to rising levels of alcohol consumption and psychiatric admissions for alcoholism.