In 1927 Lejaren à Hiller (1880–1969) produced a series of black and white art photographs entitled Sutures in Ancient Surgery evoking scenes from the distant past of surgery and medicine. Commissioned and distributed in North America by Davis & Geck, Inc. to promote sales of its surgical sutures (stitches), several depictions were erotic owing to the centrality and poses of nude female models. The first series appeared as ads in professional technical journals, then as packets assembled in paper portfolios distributed to doctors who were primarily men. The creation of Hiller's oeuvre in different forms over almost a century – journal advertisement, portfolio, book, exhibit, magazine features and textbook illustration – highlights his enduring broad appeal, although his work has since been subject to criticism because of its perceived sexism. At its root, Sutures was an advertising medium that connected a seller to a potential buyer. The content and presentation of the project also connected medicine present with medicine past, which also may have helped physicians to connect with the then blossoming field of medical history. The appeal Sutures may have had for a past male medical culture would not resonate with the more gender-inclusive and less overtly sexist medical profession of today, which also prompts discussion of the associations across art, obscenity, medicine and society. My reassessment of Hiller's work based on analysis of his artwork, contemporary interviews, published critiques, Hiller's own writings and DG company records extends previous analyses as it is more comprehensive in scope and also considers more fully works by Hiller antecedent to Sutures that probably greatly influenced it, such as photopoetry books, other advertising projects and his silent movie films.

This paper provides a broad overview of spatial, architectural, and sensory relationships between rats and humans on British and American vessels from approximately the 1850s–1950s. Taking rats as my primary historical actors, I show how humans attempted to prevent the movement of these animals between ports across three periods. Firstly, the mid- to- late-nineteenth century, where few attempts were made to prevent rats from boarding ships, and where a multiplicity of human/rat relationships can be located. Secondly, the 1890s–1920s, in which port authorities erected anti-rat borders to lock these animals on land or at sea. Finally, the 1920s–50s, where ships were reconstructed to eliminate all possibilities of rodent inhabitation and to interrupt their transit between ports. Ship rats, I argue, not only demonstrate the fragility of historical rodent-control efforts, but also encourage oceanic historians to consider how animals have negotiated and shaped boundaries between spheres of land and sea.

Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.

In 1974, Herbert Freudenberger introduced the phrase ‘Burnout in Healing Professional Workers’. Despite the existence of numerous investigations on physician burnout, only a few studies on its historical aspects can be found. This is the first research to present historical evidence on ‘physician burnout’ as pointed out in the book ‘Adab al-Tabib’ written by Ruhawi (9th century AD). He is shown to have an understanding of this concept by talking about job stress in his book, although he offers no exact equivalent definition for this state. In fact, finding an equivalent term to 20th century burnout in a book written a thousand years ago is almost impossible. Most interestingly, the same preventive strategies for physician burnout and its causes as those scientifically discovered in recent years can be evidenced to have been introduced by Ruhawi. Hence, ‘Adab al-Tabib’ is an outstanding work on physician burnout in the medieval era.

The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.

Some ideas return after the briefest of exiles: reductionism is back in vogue. Existential questions – about who we are, about our origins and future, about what is valuable – no longer require difficult soul searching, especially when straightforward answers are expected from the neurosciences. History is being rewritten with the brain as its centrepiece; the search for great men and big ideas of the past begins again. William Cullen (1710–90), whose work on neurosis was once part of the history of psychoanalysis, is now well placed to become part of such a neuro-history. This article attempts to subvert this process, by rebuilding the original meaning of neurosis through Cullen’s physiological and medical works, in comparison with his predecessor, Robert Whytt (1714–66), and illustrating this meaning using one particular neurosis: hypochondriasis. The result is a more complicated version of neurosis which, importantly, carries significant insights into the nature and practice of medicine. Moreover, this article examines how Cullen’s standing fell in the 1820s as British physicians and surgeons turned to an idea which promised to reform medicine: pathological anatomy. When these hopes faded, Cullen became a figure obsessed with the nerves. This image has survived to the present, a blank canvas onto which any theory can be projected. It also values precisely what Cullen warned against: simplistic explanations of the body and disease, and unthinking confidence in the next big idea or silver bullet. Neurosis was not simply a nervous ailment, but it is a warning against reductionism in history making.

Non-controversially, the full version of this article argues that the crisis in British higher education will impoverish teaching and research in the arts and humanities; cut even more deeply into these areas in the post-1992 sector; and threaten the integrity of every small sub-discipline, including the history of medicine. It traces links between the Thatcherite reforms of the 1980s and the near-privatisation of universities proposed by the Browne Report and partly adopted by the coalition. The article ends by arguing that it would be mistaken to expect any government-driven return to the status quo ante. New ideas and solutions must come from within. As economic and cultural landscapes are transformed, higher education will eventually be rebuilt, and the arts and social sciences, including medical history, reshaped in wholly unexpected ways. This will only happen, however, if a more highly politicised academic community forges its own strategies for recovery.

Joseph Toynbee (1815–1866) is considered one of the fathers of modern otology. He spent his whole life in London, studying and describing the anatomy and pathology of the main diseases of the ear. This paper presents some of the motivations behind Toynbee's decision to specialise in otology, by examining several of his letters published under the signature ‘J. T.’ in The Lancet between 1838 and 1839. Frustrated by the weakened state of aural surgery in Britain, and by the popularity of several ‘quacks aurists’ (including John Harrison Curtis, William Wright and Alexander Turnbull), Toynbee insisted that the study of the ear needed to distance itself from quackery and rebuild itself upon a scientific foundation. This paper evaluates several exchanges between Toynbee and Curtis, Wright and Turnbull.