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.

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.

The elderly in palliative care are confronted with difficult decisions relating to treatments. The philosophy of palliative care, namely, including the patient and his/her family right away, leads the doctor to consult with the two parties involved when choosing a treatment. As no theoretical model allows us to understand how the decision-making process hinges on the trio (a capable elderly person, a family caregiver, and the doctor) in a context of palliative care, we propose one which was developed from three strategies of document analysis: theoretical synthesis, theoretical analysis, and theoretical derivation. According to our model, the decision-making process depends on individual factors influencing the decision of the participant, expectations and attitudes as to the role, the level of confidence amongst the parties involved, the manner in which they communicate with each other, their mutual understanding of the clinical and ethical issues, and, finally, their ability to cooperate.

What people know and how people feel about type 2 diabetes will affect demand for early identification of the disease at an asymptomatic stage. This paper reports on the selected findings from a broader study of the attitudes and perceptions of GPs, nurses and patients about screening for type 2 diabetes. Purposive sampling was used to identify several practices across north-east England, and data were collected via semi-structured interviews with GPs, nurses and patients from these practices. Interview transcripts were analysed by drawing on the principles of grounded theory, with the aid of NUD*IST software. This paper focuses upon the perceived seriousness of this condition, and the implications such perceptions may have in practice. Results indicate a marked variation in perceptions of seriousness between health practitioners and patients. This diversity can be explored via three overlapping frameworks identified during the study: medical, political and personal. A medical framework suggests that individuals' perceptions are guided by a medical model. This links the seriousness of type 2 diabetes with concepts of prevention and cure, a need for individual lifestyle change, bias towards younger patients and anticipated use of medication. In short, diabetes is perceived to be more serious as it becomes more medicalized. A political framework views seriousness in terms of national incentives and priorities, a recognized need for a centralized push for early detection and financial inducements. Diabetes detection is not generally thought to be attractive politically compared with systematic cancer screening. A personal framework suggests that perceptions of seriousness are determined by individual attitudes, knowledge and experiences of diabetes. The findings offer important insights into how perceptions of the seriousness of type 2 diabetes may influence detection and management of this disease in primary care.