This article provides an overview of the historiography of medical education and calls for greater attention to the connections between medical schools. It begins by reviewing research on medical education in imperial metropoles. Researchers have compared medical schools in different national contexts, traced travellers between them or examined the hierarchies that medical education created within the medical profession. The article then shows how historians have emphasised the ways in which medicine in colonial empires was shaped by negotiation, exchange, hybridisation and competition. The final part of the article introduces the special issue ‘Medical Education in Empires’. Drawing on a variety of sources in English, French, Dutch and Chinese, the special issue builds on these historiographies by juxtaposing cases of medical schools in imperial contexts since the eighteenth century. It considers who funded these medical schools and why, what models of medicine underpinned their creation, what social changes they contributed to, what life was like in these schools, who the students and teachers were and what graduates did with their medical careers. This special issue thus contributes to clarifying the role of medical education in empires and the long-term impact of empires on the medical world.

Premodern medicine used a variety of mineral substances for therapeutic purposes. The present article deals with pitch-asphalt, and, in particular, a precious kind of it called mūmiyāʾ originating in Persia. It was first described in detail in the Arabic pharmacological tradition, and its fame spread throughout the medieval Mediterranean, including Byzantium. By editing and examining for the first time a previously unexplored medieval Greek text on mūmiyāʾ, this study offers new insights into the medicinal uses of this substance. It also significantly increases our understanding of the intense cross-cultural transfer of medical knowledge from the Islamicate world to Byzantium by showing that this was not merely based on the translation of a few Arabic medical works into Greek, but was a multifaceted phenomenon involving a complex nexus of sources that require further investigation.

This essay argues that scrofula was one of several disorders, including gout, rickets, and venereal disease, that were ‘rebranded’ as hereditary in response to broader cultural changes that took place during the Restoration and eighteenth century in England. While the purposes of scrofula’s recategorisation were more political than medical, they resulted in this heretofore relatively obscure childhood ailment assuming a new prominence within both medical and popular discourses of the period. Scrofula became both emblem and proof of the links between sexual promiscuity, financial profligacy, and physiological degeneration, its symbolic status reinforced by the legal and moral language used to model processes of hereditary transmission. By likening the inheritance of scrofula to the inheritance of original sin—or, more commonly, to the inheritance of a ‘docked entail’ or damaged estate—eighteenth-century writers and artists not only made this non-inherited ailment into a sign of catastrophic hereditary decline; they also paved the way for scrofula to be identified as a disease of aristocratic vice, even though its association with crowded, unsanitary living conditions likely made it more common among the poor. By the same token, financial models of disease inheritance facilitated a bias toward paternal transmission, with scrofula often portrayed as passing, like a title or an estate, from father to son rather than from mother to daughter.

This article examines the care provided for the welfare of soldiers by the three combatant countries – China, Korea and Japan – during the East Asian War of 1592–8. Also known as the Imjin War, this large-scale military conflict can also be understood as an encounter between different state cultures and strategies of military medicine. This study focuses on cold-induced injuries, epidemic outbreaks and external wounds suffered during the war. I illuminate provision of prophylactic measures against cold by the Ming state, as well as attempts by the Sino-Chosŏn medical alliance to manage epidemics and treat wounded soldiers. I contrast these measures with the lack of similar centralised support for the Japanese forces, and examine the effect these differences had upon on military outcomes during the war. The difference in the amount of time, efforts and resources that the three combatant states devoted to sick and injured soldiers has implications not only for our understanding of the war but also for illuminating the early modern history of military medicine in East Asia. By exploring East Asian military medicine during and after the Imjin War, this article responds to recent calls for more detailed examination of histories of military medicine in premodern periods and non-European regions.

In this textual comparison of seventeenth-century herbals, I show in detail that most of the descriptions and medicinal uses of English herbs included in Culpeper’s small folio The English Physitian (1652) and its enlargement of the following year were lifted straight out of the works of John Parkinson, apothecary. This was a deliberate act by Culpeper, to make available to the people of England the best information on native plant medicines for use in treating their illnesses. He attacked the College of Physicians of London, whom the great majority of the population could not afford to engage, for trying to keep this knowledge secret. Among later historians of the herbal tradition, Culpeper’s work was not accorded the same status as the great English herbals of William Turner, John Gerard, and John Parkinson, not because this borrowing was recognised but because its astrological content worked to divert attention from the quality and source of much of its guidance on treatment. Even contemporaries of Culpeper did not recognise the extent of the borrowing. Comparisons also reveal the limitations of Culpeper’s powers of plant description and his lack of interest in the developing science of botany. The editorial decisions Culpeper made to reduce a great folio herbal to a much smaller book to be sold for 3d touch on domestic and other non-medical uses, while points of discussion common to both authors such as the doctrine of signatures and superstitious beliefs about plants are explored.

In the early nineteenth century, medical schools became a growing means of regulating medicine in the British Empire, both in the metropole and in two colonies: India and Canada. By examining the establishment of medical schools in Calcutta, Bombay, Madras, Quebec City, Montreal and Toronto between the end of the Seven Years’ War and the beginning of the Victorian era, this article argues that the rise of the British Empire was a key factor in the gradual replacement of private medical apprenticeships with institutional medical education. Although the imperial state did not implement a uniform medical policy across the British Empire, the medical schools established under its jurisdiction were instrumental in devising a curriculum that emphasised human dissection, bedside training in hospitals and organic chemistry as criteria of medical competence.

This article discusses early modern North Indian ways of expressing how barrenness could be mapped onto a woman’s maternal identity. Scholars have engaged with the historical evolution of women’s identities, focusing overwhelmingly on their economic and political potential. This article is the first to use medical and erotological sources from the seventeenth and eighteenth centuries to study women as procreative agents, and the socio-sexual anxieties prompted by infertile female bodies. Through a critical study of a wide range of medical material, I demonstrate that by the eighteenth century, several transformations in medical discourses can be mapped onto textual transmissions from Sanskrit (and Braj Bhasha) to Persian, as well as between competing but conterminously flourishing medical paradigms, Ayurveda and Yunani. While cures for childlessness have a much longer history, a new genre of ‘anonymous’ sources, particularly focused on the sexual diseases of men and women emerged in early modern North India. Lastly, my comparative methodological approach to different textual genres will complicate our understanding of early modern medical episteme and its intended audience.

Australia’s approach to its biosecurity and borders has always been two-pronged – quarantine first, vaccination second. This article asks what this combination looked like in practice by exploring two neglected smallpox vaccination campaigns directed towards Indigenous peoples in the early twentieth century. We argue these were important campaigns because they were the first two pre-emptive, rather than reactionary, vaccination programs directed towards First Nations people. Second, both episodes occurred in Australia’s northern coastline, where the porous maritime geography and proximity to Southeast Asia posed a point of vulnerability for Australian health officials. While smallpox was never endemic, (though epidemic), in Australia, it was endemic at various times and places across Southeast Asia. This shifting spectre of smallpox along the northern coastline was made even more acute for state and federal health officials because of the existing polyethnic relationships, communities, and economies. By vaccinating Indigenous peoples in this smallpox geography, they were envisioned and embedded into a ‘hygienic’ border for the protection of white Australia, entwining the two-prongs as one approach. In this article, we place public health into a recent scholarship that has ‘turned the map upside down’ to re-spatialise Australia’s history and geography to the north and its global connections, while demonstrating how particular coastlines and their connections were drawn into a national imaginary through a health lens.

The article, ‘Have we lost sleep? A reconsideration of segmented sleep in early modern England’, Medical History, 67, 2 (2023), 91–108, by Niall Boyce is devoted to criticising my historical research pertaining to 1) the predominance of segmented sleep in the pre-industrial Western world and 2) the nineteenth-century transition of sleep to today’s pattern of continuous slumber that most people in modern societies seek to achieve, albeit not always successfully. This response addresses Boyce’s reinterpretation of the evidence and indicates whether this is erroneous or selective. My analysis thereby reasserts the predominance of segmented sleep in pre-modern Western Europe. Boyce’s assessment rests not on his original investigation of primary sources but on my first study relating to segmented sleep, published in 2001. Not least of the flaws of ‘Have We Lost Sleep?’ is its surprising inattention to my subsequent works that have expanded, modified, and bolstered this initial publication.

This article studies the impact caused by the success and dissemination of Broussais’ theories on the use of leeches as a medical supply on Spanish–French trade relations, as well as its consequences for the Spanish market between 1821 and the 1860s. Analysing the documents produced by the different public administrations, together with newspaper and archival sources in both Spain and France and the literature and legislation of that period, allows us to understand the evolution of this trade and the heavy impact it had on the autochthonous population of this animal resource. The article reveals how, at the beginning of the 1820s, leeches became an important medical supply and how the demand for them increased significantly. This gave rise to a trade relation between Spain and France that led to the overexploitation of the resource, the issuing of regulations on the matter, and the search for technological solutions to increase the production of leeches.

The persistent use of neurasthenia in Asia, an out-dated diagnostic category in modern psychiatry, has confounded many psychiatrists from the 1960s. This paper attempts to understand the prevalence of neurasthenia among the lay public in post-World War II Hong Kong. It examines the social history of psychiatry and focuses on the roles of traditional Chinese medicine in shaping public perceptions and responses towards neurasthenia. This research reveals that, when psychiatrists discarded the term as an ineffective label in the 1950s, practitioners and pharmaceutical companies of Chinese medicine seized on the chance to reinvent themselves as experts in neurasthenia. By commericialising everyday distress, they provided affordable, accessible and culturally familiar healing options to the Chinese public. A case study of neurasthenia, therefore, is not simply about changing disease categories but an important example to illustrate the tensions between traditional medicine and Western psychiatry in Asia.

This article examines some of the racist features of nineteenth-century medical school curricula in the United States and the imperial networks necessary to acquire the data and specimens that underpinned this part of medical education, which established hierarchies between human races and their relationship to the natural environment. It shows how, in a world increasingly linked by trade and colonialism, medical schools were founded in the United States and grew as the country developed its own imperial ambitions. Taking advantage of the global reach of empires, a number of medical professors in different states, such as Daniel Drake, Josiah Nott and John Collins Warren, who donated his anatomical collection to Harvard Medical School on his retirement in 1847, began to develop racial theories that naturalised slavery and emerging imperialism as part of their medical teaching.

I would like to thank Professor Ekirch for his reflections on ‘Have we lost sleep?’, which contain several points that I have already responded to within the paper following his peer review of my original submission to Medical History in 2023 (Professor Ekirch having voluntarily identified himself as a reviewer in a normally double-blind process). I acknowledge that the focus of my paper was on Ekirch’s original work from 2001; if I did not engage as he would have wished with his subsequent publications, this was simply because I do not perceive the same substantial developments in his thinking and research on the subject that he does. Indeed, the present critique by Ekirch amounts essentially to more of the same: a long list of references and quotes but little detailed discussion of any individual source. As my paper demonstrates, seemingly unambiguous evidence from a brief quotation can become less clear-cut when placed in context. I am sorry if I deploy the word ‘might’ more than Ekirch would like. This reflects, I hope, a healthy degree of uncertainty and intellectual humility in my approach to the complex issue of pre-industrial sleep. To extend Ekirch’s metaphor, if the jigsaw puzzle that both he and I are trying to assemble can take the form of a cat or a dog, it is possible that its true form is neither animal. The extent to which people woke in the night in pre-industrial Europe, the duration of such awakening, and the predominant cultural attitude towards this—concern, acceptance, or indifference—are topics about which it would seem wise to avoid sweeping statements and generalisations, given the relatively long period covered and the social, cultural, and individual diversity that must be taken into consideration. I can only repeat that I think amassing more brief references, and selectively citing relatively small physiological studies and anthropological evidence from global settings, is unlikely to provide much clarity, let alone definitive answers. I welcome Professor Ekirch’s contribution to this discussion as an indication that the question of segmented sleep in early modern Europe is by no means settled but is a matter of ongoing debate.

This article is the first scholarly research focusing exclusively on the history of Jews with disabilities in the Kingdom of Poland from the 1860s to 1914. It analyses sources drawn from the Jewish press in Yiddish, Polish, and Hebrew. Areas of investigation include the hierarchy of attitudes towards different categories of individuals with disabilities, spiritual perspectives on disability, and the portrayal of disabilities within Jewish literature. The study places particular emphasis on the Jewish deaf community, given the proliferation of available source material. Drawing on the broad conceptual framework of disability studies, the authors examine the phenomenon of medicalisation, tracing its influence on Jewish public discourse over the latter half of the nineteenth century and the early decades of the twentieth.

This paper reexamines the sources used by N. Fancy and M.H. Green in “Plague and the Fall of Baghdad (1258)” (Medical History, 65/2 (2021), 157–177). Fancy and Green argued that the Arabic and Persian descriptions of the Mongol sieges in Iran and Iraq, and in particular, in the conquest of Baghdad in 1258, indicate that the besieged fortresses and cities were struck by Plague after the Mongol sieges were lifted. This, they suggested, is part of a recurrent pattern of the outbreak of Plague transmitted by the Mongol expansion across Eurasia. Fancy and Green concluded that the primary sources substantiate the theory driven by recent paleogenetic studies indicating that the Mongol conquests of the thirteenth century set the stage for the massive pandemic of the mid-fourteenth century. The link between the Plague outbreak and the Mongol siege of Baghdad relies on three near-contemporaneous historical accounts. However, our re-examination of the sources shows that the main text (in Persian) has been significantly misunderstood, and that the two other texts (in Syriac and Arabic) have been mis-contextualized, and thus not understood properly. They do not support the authors’ claim regarding Plague epidemic in Baghdad in 1258, nor do other contemporary and later Arabic texts from Syria and Egypt adduced by them, which we re-examine in detail here. We conclude that there is no evidence for the appearance of Plague during or immediately after the Mongol conquests in the Middle East, certainly not for its transmission by the Mongols.

In 1851, the colonial administration of the Dutch East Indies established a two-year program to educate young Javanese men to become vaccinators in Batavia (today’s Jakarta). During the following sixty years, the medical curriculum was expanded several times; in 1913, it consisted of a ten-year program. In 1927, the Batavia Medical School, granting degrees equivalent to those of Dutch university-affiliated medical schools, commenced operations. Consequently, a steadily increasing number of Indonesian physicians with various credentials were employed by the colonial health service, plantations, sugar factories and mines, or established private practices. They became a social group that occupied an ambiguous and even paradoxical position somewhere between Europeans and the indigenous population. During the 1910s, this inspired these physicians to obtain credentials and professional recognition equal to those of their European colleagues. Several of them became active in journalism, politics and social movements. During the 1920s, several became radicalised and criticised the nature of colonial society. In the 1930s, following the increasingly repressive nature of colonial society, most of them remained active in the public sphere while a small group dedicated itself to improving medical research and health care. After the transfer of sovereignty from the Netherlands to Indonesia on 27 December 1949, this small cadre reestablished medical education and health care, and built the Indonesian medical profession.

While larger British colonies in Africa and Asia generally had their own medical services, the British took a different approach in the South Pacific by working with other colonial administrations. Together, colonial administrations of the South Pacific operated a centralised medical service based on the existing system of Native Medical Practitioners in Fiji. The cornerstone of this system was the Central Medical School, established in 1928. Various actors converged on the school despite its apparent isolation from global centres of power. It was run by the colonial government of Fiji, staffed by British-trained tutors, attended by students from twelve colonies, funded and supervised by the Rockefeller Foundation, and jointly managed by the colonial administrations of Britain, Australia, New Zealand, France and the United States. At the time of its establishment, it was seen as an experiment in international cooperation, to the point that the High Commissioner for the Western Pacific called it a ‘microcosm of the Pacific’. Why did the British establish an intercolonial medical school in Oceania, so far from the imperial metropole? How did the medical curriculum at the Central Medical School standardise to meet the imperial norm? And in what ways did colonial encounters occur at the Central Medical School? This article provides answers to these questions by comparing archival documents acquired from five countries. In doing so, this article will pay special attention to the ways in which this medical training institution enabled enduring intercolonial encounters in the Pacific Islands.

This essay responds to Brack et al., ‘Plague and the Mongol Conquest of Baghdad (1258)? A reevaluation of the sources’, which is a critique of our 2021 essay in this journal, ‘Plague and the Fall of Baghdad (1258)’. We argue that Brack and colleagues have misunderstood our investigation as an attempt to pinpoint the exact timing of the outbreak of plague connected with the Mongol siege of Baghdad, and so believe that an altered timeframe invalidates our suggestion that plague was involved. Taking this opportunity to revisit the state of plague historiography in western Asia, we address four issues: (1) why Mongol historiography has, until recently, avoided the question of plague’s late mediaeval resurgence within the Mongol Empire and why the ‘new genetics’ of plague now makes the question unavoidable; (2) why reconstruction of the biological processes of ‘focalisation’ is now the most urgent question in plague historiography since it constitutes what we call the prodromal stage of the Black Death pandemic; (3) how a newly informed biological perspective on disease history can allow a more sensitive reading of past observers’ reports of epidemics; and finally, (4) what a plausible scenario might look like for plague’s presence in western Asia and the eastern Mediterranean region in the late-thirteenth and early-fourteenth centuries as an emerging zoonotic disease with occasional epizootic and human outbreaks, before the more catastrophic outbreaks of the 1340s commonly referred to as ‘the Black Death’.

Existing scholarship on prison diets has emphasised the role of food and its restriction as a key aspect of the deterrent system of prison discipline introduced in the 1860s. Here we suggest that a strong emphasis was placed on dietary regulation after the establishment of the reformist, but also ‘testing’, separate system of confinement in the mid-nineteenth century. While the impact of diet on the physical health of prisoners was a major concern, we argue that the psychological impact of food was also stressed, and some prison administrators and doctors argued that diet had an important protective function in preserving inmates’ mental wellbeing. Drawing on a wide range of prison archives and official reports, this article explores the crucial role of prison medical officers in England and Ireland in implementing prison dietaries. It highlights the importance and high level of individual adaptations to dietary scales laid down centrally, as a means of utilising diet as a tool of discipline or as an intervention to improve prisoners’ health. It examines the forays of some prison doctors into dietary experiments, as they investigated the impact of different dietaries or made more quotidian adjustments to food intake, based on local conditions and food supplies. The article concludes that, despite central policies geared to establishing uniformity and interest in new scientific discourses on nutrition, a wide range of practices were pursued in individual prisons, mostly shaped by practical rather than scientific factors, with many prison medical officers asserting their autonomy in making dietary adjustments.

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women’s social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists’ campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act’s eugenics clause, sometimes verbatim. This essay analyses ALRA’s role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to ‘voluntary motherhood’ in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities.