This article examines the changing nature of public health services and their relationship with the public in post-war Britain by an analysis of the exhibitions mounted by Medical Officers of Health (MOsH) in London. Focusing on the period 1948–71, the article explores a time when public health practice, and the problems it faced, were in flux. A decline in infectious disease and an increase in chronic conditions linked to lifestyle required a new role for public health services. Exhibitions were one of several methods that MOsH used to inform the public about dangers to their health, but also to persuade them to change their behaviour. The exhibition, though, offers a unique insight into the relationship between public health authorities and the public, as exhibitions brought MOsH into direct contact with people. It is suggested that in the MOsH exhibitions we can find signs of a new relationship between public health practitioners and the public. Whilst elements of the pre-war, often moralistic ideology of public health services could still be detected, there is also evidence of a more nuanced, responsive dynamic between practitioners and the people. By the end of the 1960s, ‘the public’ was increasingly being thought of as a collection of ‘publics’, including individuals, target groups and vocal respondents.

Current policy and practice directed towards people with learning disabilities originates in the deinstitutionalisation processes, civil rights concerns and integrationist philosophies of the 1970s and 1980s. However, historians know little about the specific contexts within which these were mobilised. Although it is rarely acknowledged in the secondary literature, MIND was prominent in campaigning for rights-based services for learning disabled people during this time. This article sets MIND’s campaign within the wider historical context of the organisation’s origins as a main institution of the inter-war mental hygiene movement. The article begins by outlining the mental hygiene movement’s original conceptualisation of ‘mental deficiency’ as the antithesis of the self-sustaining and responsible individuals that it considered the basis of citizenship and mental health. It then traces how this equation became unravelled, in part by the altered conditions under the post-war Welfare State, in part by the mental hygiene movement’s own theorising. The final section describes the reconceptualisation of citizenship that eventually emerged with the collapse of the mental hygiene movement and the emergence of MIND. It shows that representations of MIND’s rights-based campaigning (which have, in any case, focused on mental illness) as individualist, and fundamentally opposed to medicine and psychiatry, are inaccurate. In fact, MIND sought a comprehensive community-based service, integrated with the general health and welfare services and oriented around a reconstruction of learning disabled people’s citizenship rights.

This article shows how funding research on Alzheimer’s disease became a priority for the British Medical Research Council (MRC) in the late 1970s and 1980s, thanks to work that isolated new pathological and biochemical markers and showed that the disease affected a significant proportion of the elderly population. In contrast to histories that focus on the emergence of new and competing theories of disease causation in this period, I argue that concerns over the use of different assessment methods ensured the MRC’s immediate priority was standardising the ways in which researchers identified and recorded symptoms of Alzheimer’s disease in potential research subjects. I detail how the rationale behind the development of standard assessment guidelines was less about arriving at a firm diagnosis and more about facilitating research by generating data that could be easily compared across the disciplines and sites that constitute modern biomedicine. Drawing on criticism of specific tests in the MRC’s guidelines, which some psychiatrists argued were ‘middle class biased’, I also show that debates over standardisation did not simply reflect concerns specific to the fields or areas of research that the MRC sought to govern. Questions about the validity of standard assessment guidelines for Alzheimer’s disease embodied broader concerns about education and social class, which ensured that distinguishing normal from pathological in old age remained a contested and historically contingent process.

A pressing question during the first half-decade of the third plague pandemic (1894–9) was what was a ‘suitable soil’ for the disease. The question related to plague’s perceived ability to disappear from a given city only to reappear at some future point; a phenomenon that became central to scientific investigations of the disease. However, rather than this simply having a metaphorical meaning, the debate around plague’s ‘suitable soil’ actually concerned the material reality of the soil itself. The prevalence of plague in the working-class neighbourhood of Taipingshan during the first major outbreak of the pandemic, in 1894 in Hong Kong, led to an extensive debate regarding the ability of the soil to harbour and even spread the disease. Involving experiments, which were seen as able to procure evidence for or against the demolition or even torching of the area, scientific and administrative concerns over the soil rendered it an unstable yet highly productive epistemic thing. The spread of plague to India further fuelled concerns over the ability of the soil to act as the medium of the disease’s so-called true recrudescence. Besides high-profile scientific debates, hands-on experiments on purifying the soil of infected houses by means of highly intrusive methods allowed scientists and administrators to act upon and further solidify plague’s supposed invisibility in the urban terrain. Rather than being a short-lived, moribund object of epidemiological concern, this paper will demonstrate that the soil played a crucial role in the development of plague as a scientifically knowable and actionable category for modern medicine.

This paper analyses how the 1950–61 conflict between Portugal and India over the territories that constituted Portuguese India (Goa, Daman and Diu) informed Portugal’s relations with the World Health Organization’s Regional Office for South East Asia (SEARO). The ‘Goa question’ determined the way international health policies were actually put into place locally and the meaning with which they were invested. This case study thus reveals the political production of SEARO as a dynamic space for disputes and negotiations between nation-states in decolonising Asia. In this context, health often came second in the face of contrasting nationalistic projects, both colonial and post-colonial.

The Vietnam War has long been regarded as pivotal in the history of the Republic of Korea, although its involvement in this conflict remains controversial. While most scholarship has focused on the political and economic ramifications of the war – and allegations of brutality by Korean troops – few scholars have considered the impact of the conflict upon medicine and public health. This article argues that the war had a transformative impact on medical careers and public health in Korea, and that this can be most clearly seen in efforts to control parasitic diseases. These diseases were a major drain on military manpower and a matter of growing concern domestically. The deployment to Vietnam boosted research into parasitic diseases of all kinds and accelerated the domestic campaign to control malaria and intestinal parasites. It also had a formative impact upon the development of overseas aid.

The influence of a range of actors is discernible in nutrition projects during the period after the Second World War in the South Pacific. Influences include: international trends in nutritional science, changing ideas within the British establishment about state responsibility for the welfare of its citizens and the responsibility of the British Empire for its subjects; the mixture of outside scrutiny and support for projects from post-war international and multi-governmental organisations, such as the South Pacific Commission. Nutrition research and projects conducted in Fiji for the colonial South Pacific Health Service and the colonial government also sought to address territory-specific socio-political issues, especially Fiji’s complex ethnic poli,tics. This study examines the subtle ways in which nutrition studies and policies reflected and reinforced these wider socio-political trends. It suggests that historians should approach health research and policy as a patchwork of territorial, international, and regional ideas and priorities, rather than looking for a single causality.

Within the colonial setting of the Belgian Congo, the process of cutting the body, whether living or dead, lent itself to conflation with cannibalism and other fantastic consumption stories by both Congolese and Belgian observers. In part this was due to the instability of the meaning of the human body and the human corpse in the colonial setting. This essay maps out different views of the cadaver and personhood through medical technologies of opening the body in the Belgian Congo. The attempt to impose a specific reading of the human body on the Congolese populations through anatomy and related Western medical disciplines was unsuccessful. Ultimately, practices such as surgery and autopsy were reinterpreted and reshaped in the colonial context, as were the definitions of social and medical death. By examining the conflicts that arose around medical technologies of cutting human flesh, this essay traces multiple parallel narratives on acceptable use and representation of the human body (Congolese or Belgian) beyond its medical assignation.

In 2014 the World Health Organization (WHO) was widely criticised for failing to anticipate that an outbreak of Ebola in a remote forested region of south-eastern Guinea would trigger a public health emergency of international concern (pheic). In explaining the WHO’s failure, critics have pointed to structural restraints on the United Nations organisation and a leadership ‘vacuum’ in Geneva, among other factors. This paper takes a different approach. Drawing on internal WHO documents and interviews with key actors in the epidemic response, I argue that the WHO’s failure is better understood as a consequence of Ebola’s shifting medical identity and of triage systems for managing emerging infectious disease (EID) risks. Focusing on the discursive and non-discursive practices that produced Ebola as a ‘problem’ for global health security, I argue that by 2014 Ebola was no longer regarded as a paradigmatic EID and potential biothreat so much as a neglected tropical disease. The result was to relegate Ebola to the fringes of biosecurity concerns just at the moment when the virus was crossing international borders in West Africa and triggering large urban outbreaks for the first time. Ebola’s fluctuating medical identity also helps explain the prominence of fear and rumours during the epidemic and social resistance to Ebola control measures. Contrasting the WHO’s delay over declaring a pheic in 2014, with its rapid declaration of pheics in relation to H1N1 swine flu in 2009 and polio in 2014, I conclude that such ‘missed alarms’ may be an inescapable consequence of pandemic preparedness systems that seek to rationalise responses to the emergence of new diseases.

In the wake of the Second World War there was a movement to counterbalance the apparently increasingly technical nature of medical education. These reforms sought a more holistic model of care and to put people – rather than diseases – back at the centre of medical practice and medical education. This article shows that students often drove the early stages of education reform. Their innovations focused on relationships between doctors and their communities, and often took the form of informal discussions about medical ethics and the social dimensions of primary care. Medical schools began to pursue ‘humanistic’ education more formally from the 1980s onwards, particularly within the context of general practice curricula and with a focus on individual doctor–patient relationships. Overall from the 1950s to the 1990s there was a broad shift in discussions of the human aspects of medical education: from interest in patient communities to individuals; from social concerns to personal characteristics; and from the relatively abstract to the measurable and instrumental. There was no clear shift from ‘less’ to ‘more’ humanistic education, but rather a shift in the perceived goals of integrating human aspects of medical education.The human aspects of medicine show the importance of student activism in driving forward community and ethical medicine, and provide an important backdrop to the rise of competencies within general undergraduate education.

Through an examination of previously unseen archival records, including patients’ letters, this article examines the treatment and experiences of patients in late Victorian Broadmoor Criminal Lunatic Asylum and stakes the place of this institution within the broader history of therapeutic regimes in British asylums. Two main arguments are put forth. The first relates to the evolution of treatment in Victorian asylums. Historians tend to agree that in the 1860s and 1870s ‘psychiatric pessimism’ took hold, as the optimism that had accompanied the growth of moral treatment, along with its promise of a cure for insanity, abated. It has hitherto been taken for granted that all asylums reflected this change. I question this assumption by showing that Broadmoor did not sit neatly within this framework. Rather, the continued emphasis on work, leisure and kindness privileged at this institution into the late Victorian period was often welcomed positively by patients and physicians alike. Second, I show that, in Broadmoor’s case, moral treatment was determined not so much by the distinction between the sexes as the two different classes of patients – Queen’s pleasure patients and insane convicts – in the asylum. This distinction between patients not only led to different modes of treatment within Broadmoor, but had an impact on patients’ asylum experiences. The privileged access to patients’ letters that the Broadmoor records provide not only offers a new perspective on the evolution of treatment in Victorian asylums, but also reveals the rarely accessible views of asylum patients and their families on asylum care.

This paper, based on World Health Organization and Sri Lankan sources, examines the attempts to control tuberculosis in Sri Lanka from independence in 1948. It focuses particularly on the attempt in 1966 to implement a World Health Organization model of community-orientated tuberculosis control that sought to establish a horizontally structured programme through the integration of control into the general health services. The objective was to create a cost- effective method of control that relied on a simple bacteriological test for case finding and for treatment at the nearest health facility that would take case detection and treatment to the rural periphery where specialist services were lacking. In the late 1940s and early 1950s, Sri Lanka had already established a specialist control programme composed of chest clinics, mass X-ray, inpatient and domiciliary treatment, and social assistance for sufferers. This programme had both reduced mortality and enhanced awareness of the disease. This paper exposes the obstacles presented in trying to impose the World Health Organization’s internationally devised model onto the existing structure of tuberculosis control already operating in Sri Lanka. One significant hindrance to the WHO approach was lack of resources but, equally important, was the existing medical culture that militated against its acceptance.

Western literature has focused on medical plurality but also on the pervasive existence of quacks who managed to survive from at least the eighteenth to the twentieth century. Focal points of their practices have been their efforts at enrichment and their extensive advertising. In Greece, empirical, untrained healers in the first half of the twentieth century do not fit in with this picture. They did not ask for payment, although they did accept ‘gifts’; they did not advertise their practice; and they had fixed places of residence. Licensed physicians did not undertake a concerted attack against them, as happened in the West against the quacks, and neither did the state. In this paper, it is argued that both the protection offered by their localities to resident popular healers and the healers’ lack of demand for monetary payment were jointly responsible for the lack of prosecutions of popular healers. Moreover, the linking of popular medicine with ancient traditions, as put forward by influential folklore studies, also reduced the likelihood of an aggressive discourse against the popular healers. Although the Greek situation in the early twentieth century contrasts with the historiography on quacks, it is much more in line with that on wise women and cunning-folk. It is thus the identification of these groups of healers in Greece and elsewhere, mostly through the use of oral histories but also through folklore studies, that reveals a different story from that of the aggressive discourse of medical men against quacks.

This article explores the internationalisation of tobacco control as a case study in the history of international health regulation. Contrary to the existing literature on the topic, it argues that the history of international anti-smoking efforts is longer and richer than the making of the World Health Organisation’s Framework Convention on Tobacco Control in the early twenty-first century. It thereby echoes the point made by other scholars about the importance of history when making sense of contemporary global health. Specifically, the article shows how the internationalisation of tobacco control started in the 1950s through informal contacts between scientists working on cancer research and how these initial interactions were followed by a growing number of more formal initiatives, from the World Conferences on Tobacco or Health to the Bloomberg Initiative to Reduce Tobacco Use. Rather than arranging these efforts in a linear narrative of progress culminating with the Framework Convention on Tobacco Control, we take anthropological claims about global health’s uneven terrain seriously and portray a history of international tobacco control marked by ruptures and discontinuities. Specifically, we identify three successive periods, with each of them characterised by specific understandings of international action, tobacco control expertise, advocacy networks and funding strategies.

This article examines a fifteenth-century remedy book, Oxford, Bodleian Library, Rawlinson c. 299, and describes its collection of 314 medieval medical prescriptions. The recipes are organised broadly from head to toe, and often several remedies are offered for the same complaint. Some individual recipes are transcribed with modern English translations. The few non-recipe texts are also noted. The difference between a remedy book and a leechbook is explained, and this manuscript is situated in relation to other known examples of late medieval medical anthologies. The particular feature that distinguishes Oxford, Bodleian Library, Rawlinson c. 299 from other similar volumes is the evidence that it continued to be used during the sixteenth century. This usage was of two kinds. Firstly, the London lawyer who owned it not only inscribed his name but annotated the original recipe collection in various ways, providing finding-aids that made it much more user-friendly. Secondly, he, and other members of his family, added another forty-three recipes to the original collection (some examples of these are also transcribed). These two layers of engagement with the manuscript are interrogated in detail in order to reveal what ailments may have troubled this family most, and to judge how much faith they placed in the old remedies contained in this old book. It is argued that the knowledge preserved in medieval books enjoyed a longevity that extended beyond the period of the manuscript book, and that manuscripts were read and valued long after the advent of printing.

Writing the recent history of mental health services requires a conscious departure from the historiographical tropes of the nineteenth and twentieth centuries which have emphasised the experience of those identified (and legally defined) as lunatics and the social, cultural, political, medical and institutional context of their treatment. A historical narrative structured around rights (to health and liberty) is now complicated by the rise of new organising categories such as ‘costs’, ‘risks’, ‘needs’ and ‘values’. This paper, drawing on insights from a series of witness seminars attended by historians, clinicians and policymakers, proposes a programme of research to place modern mental health services in England and Wales in a richer historical context. Historians should recognise the fragmentation of the concepts of mental illness and mental health need, acknowledge the relationship between critiques of psychiatry and developments in other intellectual spheres, place the experience of the service user in the context of wider socio-economic and political change, understand the impacts of the social perception of ‘risk’ and of moral panic on mental health policy, relate the politics of mental health policy and resources to the general determinants of institutional change in British central and local government, and explore the sociological and institutional complexity of the evolving mental health professions and their relationships with each other and with their clients. While this is no small challenge, it is perhaps the only way to avoid the perpetuation of ‘single-issue mythologies’ in describing and accounting for change.

The forgotten dream proved central to the early development of Sigmund Freud’s psychoanalytic technique in The Interpretation of Dreams (1900). However, little attention has been paid to the shifting uses of forgotten dreams within psychotherapeutic practice over the course of the twentieth century. This paper argues that post-war psychotherapists in London, both Jungian and Freudian, developed a range of subtly different approaches to dealing with their patients’ forgotten dreams. Theoretical commitments and institutional cultures shaped the work of practitioners including Donald Winnicott, Melanie Klein, Anna Freud, and Edward Griffith. By drawing on diaries and case notes, this paper also identifies the active role played by patients in negotiating the mechanics of therapy, and the appropriate response to a forgotten dream. This suggests a broader need for a detailed social history of post-Freudian psychotherapeutic technique, one that recognises the demands of both patients and practitioners.

This article presents a new, detailed catalogue of the Greek manuscripts at the Wellcome Library in London. It consists of an introduction to the history of the collection and its scholarly importance, followed by separate entries for each manuscript. Each entry identifies the text(s) found in the respective manuscript – including reference to existing printed edition(s) of such texts – and gives a physical description of the codex, details on its provenance and bibliographical references.

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.

During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain’s leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient’s military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria.