This article explores the ways in which risk and responsibility were conceptualised in the late nineteenth and early twentieth centuries by surgeons, their patients and the lay public. By this point surgery could be seen, simultaneously, as safe (due to developments in surgical science) and increasingly risky (because such progress allowed for greater experimentation). With the glorification of the heroic surgeon in the late Victorian and early Edwardian period came a corresponding, if grudging, recognition that successful surgery was supported by a team of ancillary professionals. In theory, therefore, blame for mistakes could be shared amongst the team; in practice, this was not always the case. Opening with an examination of the May Thorne negligence case of 1904, I will also, in the latter third of this piece, focus on surgical risks encountered by women surgeons, themselves still relatively new and, therefore, potentially risky individuals. A brief case study of the ways in which one female-run institution, the New Hospital for Women, dealt with debates surrounding risk and responsibility concludes this article. The origin of the risks perceived and the ways in which responsibility was taken (or not) for risky procedures will provide ways of conceptualising what ‘surgical anxiety’ meant in the 1890s and 1900s.

Historical accounts of colonial science and medicine have failed to engage with the Colonial Office’s shift in focus towards the support of research after 1940. A large new fund was created in 1940 to expand activities in the colonies described as fundamental research. With this new funding came a qualitative shift in the type of personnel and activity sought for colonial development and, as a result, a diverse group of medical and technical officers existed in Britain’s colonies by the 1950s. The fact that such variety existed amongst British officers in terms of their qualifications, institutional locations and also their relationships with colonial and metropolitan governments makes the use of the term ‘expert’ in much existing historical scholarship on scientific and medical aspects of empire problematic. This article will consider how the Colonial Office achieved this expansion of research activities and personnel after 1940. Specifically, it will focus on the reasons officials sought to engage individuals drawn from the British research councils to administer this work and the consequences of their involvement for the new apparatus established for colonial research after 1940. An understanding of the implications of the application of the research council system to the Colonial Empire requires engagement with the ideology promoted by the Agricultural Research Council (ARC) and Medical Research Council (MRC) which placed emphasis on the distinct and higher status of fundamental research and which privileged freedom for researchers.

This article aims to explain why the notion of mania puerperalis, or puerperal insanity, was not used in the Netherlands to exonerate women accused of infanticide, in contrast to other countries. It applies the concept of ‘travelling knowledge’ as an approach to the history of forensic medicine, pointing to the fields of medicine and law as contact zones inviting, promoting or barring the transmission of knowledge. Although the notion of mania puerperalis was known in the Netherlands from 1822 on, psychiatric expertise was not requested in actual court cases of infanticide for several reasons. First, physicians and legal scholars continued to doubt the existence of this form of mania. Moreover, it was not always directly connected to infanticide. Also, the specific formulation of the law strongly determined what medical evidence was needed in court cases. Not only did the Code Pénal generally emphasise material evidence, the laws on infanticide specifically mentioned fear and therefore an additional reference to the mental condition of the accused was not needed. Most importantly, the article argues that the existing vocabulary on emotion, both vernacular and medical, already allowed for an analysis of psychic components.

Significant attention has been paid to the history of public health in England during the final part of the twentieth century. Within this, however, the field that came to be known as specialist health promotion (SHP) has been relatively neglected. Between 1980 and 2000 those working in this field, generally known as health promotion specialists (HPSs), enjoyed a relative rise in policy and practice prominence before SHP was effectively abandoned by government and others charged with developing and sustaining public-health structures. This paper seeks to explain why the fall of SHP is important; to move towards explaining its rise and decline; and to argue for greater historical attention to be paid to an important but neglected field within health and health care. Essentially, SHP emerged from a set of loose and contingent practices known as health education. A range of important social, economic, organisational and political influences contributed to the slow construction of a putative specialism in health promotion, accompanied by the desire on the part of some (but not all) HPSs to ‘professionalise’ their role. Finally the projects of both specialisation and professionalisation failed, again as a result of then prevailing organisational and political influences. The importance of such a failure in a so-called era of public health is discussed. In the light of this, the paper concludes by briefly setting out an agenda for further research related to the history of SHP.

In 1965 Jamaica was declared free of malaria by the World Health Organisation (WHO), thus ending centuries of death and suffering from the disease. This declaration followed the successful completion of the WHO’s Malaria Eradication Programme (MEP) on the island, initiated in 1958. This account first explores the antecedent control measures adopted by the government up to the MEP. These, as advocated by the previous malaria ‘experts’ who had reported on the disease on the island concentrated on controlling the vector and the administration of quinine for individual protection. Although Jamaica suffered no catastrophic epidemics of island-wide scope, malaria was a constant cause of mortality and morbidity. Major change came in the wake of the Second World War within the changing political context of national independence and international development. In 1957 the Jamaican government joined the global WHO programme to eradicate malaria. The Jamaican campaign exposes many of the problems noted in other studies of such top–down initiatives in their lack of attention to the particular circumstances of each case. Despite being described as ‘a textbook pattern’ of malaria eradication, the MEP in Jamaica suffered from a lack of sufficient preparation and field knowledge. This is most obviously illustrated by the fact that all literature on the programme sent to Jamaica in the first two years was in Spanish. That the MEP exploited the technological opportunity provided by dichlorodiphenyltrichloroethane (DDT) with advantage in Jamaica is not disputed but as this analysis illustrates this success was by no means guaranteed.

In the nineteenth century the medicinal leech Hirudo medicinalis evolved into a lucrative commodity in great demand throughout the western world. In less than a century its trade became big business by any measure, involving tens of millions of animals shipped to every inhabited continent. In this context Ireland is particularly instructive in that it was the first country in Europe to exhaust its supply of native leeches. Concomitantly, it was also the first country to import leeches from abroad, as early as 1750. Being an island with manageable border controls, and a clearly definable medical market, Ireland serves superbly as a microcosm of the leech as a worldwide commodity. Being a relative small country it is possible for the first time to gain a balanced perspective of various economic factors underlying this trade, including supply and demand, exploitation of natural resources, and an evolving network of competitive traders.

This paper addresses these and other aspects of the leech trade in Ireland. The principal, and unexpected, finding of this paper is that leeches were unequivocally very expensive in Ireland and became a significant drain on hospital budgets. As such, they found little use amongst the Irish poor. An estimate of several million leeches were imported into Ireland in the nineteenth century, a practice which continued into the twentieth. They were imported initially from Wales and then from France following the defeat of Napoleon, but the bulk came ultimately from Hamburg, via importers in England.