The French human sciences and the crafting of modern subjectivity,
Laurens Schlicht opens the volume at the moment of the French Revolution,
which inculcated a profound sense of moral and political shock within its
citizens. Writers within medicine, politics, and the developing human
sciences maintained that it had been necessary to inflict this kind of shock
in order to dismantle the rigid structures of society and make way for a
radically new regime. Sustained metaphors of the medicalised human body, the
social body, and the body politic commingled in the critical questions that
were raised about the relationship between individuals and their wider
social collective, and about the ways in which the passions might be either
stirred into action or carefully regulated by external influences.
Manifestations of this conscious interaction between medical and political
spheres included the emergent psychiatric practice of intentionally shocking
patients as a form of therapy, and the evolving instruction of deaf-mute
pupils, as schools and asylums provided experimental spaces for controlling
and adjusting the passions. In addition to an overt politicisation of the
body and its responses to shock and strain, these discussions carried
sustained analyses of the medicalised human body, and informed an evolving
scientific practice directed towards an essentialised sphere of
Health as moral economy in the long nineteenth century
Christopher Hamlin takes up the unstable and often polarised relationship
between cultural experience and interpretation on the one hand, and
biomedical objectivity on the other. In so doing, he draws attention to a
phenomenon which is so frequently missing from current scholarship: embodied
subjectivity. The chapter ranges widely from public health archives to
literary texts, interrogating E. P. Thompson’s seminal concept of the ‘moral
economy’ through the social history of health, and questioning how we might
meaningfully register the experiences of those whose words and emotions are
lost to history. Questioning the very voices and vocabularies through which
the social history of health is constructed, Hamlin recognises both the
usefulness and the limitations of our approaches to illness and the history
of medicine, while adopting an integrative, holistic approach to notions of
disease. Paralleling the historical figure of the nuisance inspector with
the gamekeeper (or lover) in D. H. Lawrence’s Lady Chatterley’s Lover, and
the tales of patients of Hardwicke Hospital, Dublin, with the complaints of
Agnes Fleming in Charles Dickens’s Oliver Twist, he opens up the
possibilities of work which crosses literary and medical histories as a
context in which the formation of an embodied subjectivity might be
Architecture, asylum and community in twentieth-century mental health
Sarah Chaney and Jennifer Walke
This chapter explores the value and relevance of a combined academic and
public engagement approach to the history of medicine. The authors consider
a specific mental health project at the Bethlem Museum of the Mind, in the
context of a longer tradition of service user involvement in mental health
research and museology. It is argued that the project’s approach presented a
unique opportunity for mental health education and the reduction of stigma.
These elements of the project informed the historical focus, resulting in a
more inclusive history than in many institutional histories of psychiatry,
focusing on the importance of space, place and architecture in
twentieth-century psychiatry. The chapter concludes that community
engagement within a museum setting enriches the history of medicine as a
discipline and vice versa.
The creation of spaces conducive to healing is a critical aspect of the provision of good nursing care. The nursing sisters of the British Army, having trained in the British hospital system would have been well versed in the need to create and maintain and environment in which healing could take place. The zones into which they were posted during the Second World War and the spaces they were given in which to care for their patients, were however, rarely either favourable to health or to the ‘serenity and security’ needed for recovery. Extreme weather conditions, limited water supplies, equipment and electricity combined to hinder all aspects of patient care. The often hostile places in which nurses worked demanded that they develop clinical skills and the ability to improvise and innovate in order create healing spaces for their soldier-patients. However, as the chapter argues it was the highly feminised home-maker work that created these spaces, which the nurses themselves credited to be an essential aspect to the healing process in which they were the critical performers.
Nursing work and nurses’ space in the Second World War: a gendered construction
The introduction contextualises the Second World War and the position of nurses within it. It argues that the developments in weapons’ manufacture and transport technologies created a war in which mass killing and maiming could be achieved across the globe. The injuries and diseases caused by the mobility of troops and modern weaponry demanded a highly responsive medical service close to the action. This introductory chapter therefore provides a frame for the book within the historiography of wartime medical services, women’s participation in war and that of nurses more specifically. Negotiating Nursing uses written and oral testimony to explore the work and experiences of nurses on active service overseas. The introduction examines the nature of the sources and the value of personal testimony to the history of Second World War military nursing.
Negotiating nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged men within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men physically, emotionally and spiritually from the battlefield and for the war, despite concerns about their presence on the frontline. The book maps the developments in nurses’ work as the Q.A.s created a legitimate space for themselves in war zones and established nurses’ position as the expert at the bedside. Using a range of personal testimony the book demonstrates how the exigencies of war demanded nurses alter the methods of nursing practice and the professional boundaries in which they had traditionally worked, in order to care for their soldier-patients in the challenging environments of a war zone. Although they may have transformed practice, their position in war was highly gendered and it was gender in the post-war era that prevented their considerable skills from being transferred to the new welfare state, as the women of Britain were returned to the home and hearth. The aftermath of war may therefore have augured professional disappointment for some nursing sisters, yet their contribution to nursing knowledge and practice was, and remains, significant.
The chapter examines the changes to the dominion of nursing work on active service overseas. The chapter first explores the extensions to the nursing role, most particularly the care of wounds and burns. This is followed by a discussion of the expansion of nursing duties into those that had hitherto been the domain of medicine. These roles include the commencement and management of blood transfusions, surgical work and anaesthesia. Finally the chapter considers ‘new work’, the most critical of which was the administration and use of penicillin. The constantly shifting requirements of war nursing prevented Army nurses from remaining in a professional comfort zone of accepted roles and regimes. The experience of living with uncertainty may have caused anxieties for some, but the active participation in new treatment modalities suggests that nurses who went to war were keen to move beyond the normal boundaries of nursing practice and many relished the opportunity to do so. The chapter argues that the developments in practice and the increased confidence nursing sisters displayed with this new work altered their working relationships with medical officers from one of deference to one of collegiality, enabling more productive decisions for their soldier-patients’ care.
Military success in war was contingent on men sustaining a determination to fight. Persuading men to continue fighting or returning them to combat after illness or injury depended on maintaining their morale. The use of female nurses in upholding this resolve was integral to the war effort. The chapter explores the value of the presence of women in hospital wards and in social environments on active service overseas. It considers the occasional antipathy of military authorities and male colleagues to the location of female nurses in war zones. However, it is argued through the provision of expert clinical care, domestic acumen and the use of their ‘female-selves’, nurses were able to salvage men in readiness to return to battle. Nursing sisters thus created a space for themselves in frontline duties. However, the chapter argues, this was not without its difficulties. As single, white women in far-flung places, this position situated nurses in a liminal place between the respectable European colonial wife and the ‘biohazardous’ local women. The chapter acknowledges these difficulties, but also demonstrates how the nurses negotiated their way through these contradictions to their advantage and for those in their care.
The chapter considers the civilian world into which the Q.A.s returned at the end of the war and explores the options they faced. It begins with the immediate aftermath of war and the opportunities for interesting and worthwhile work that would only exacerbate the nursing sisters’ difficulties on demobilisation. This is followed by a consideration of the return to Britain and the options open for professional practice. The chapter argues that for some the option of interesting work remained, either in the colonial service or the military. However the main professional opening for returning nurses was the crisis ridden civilian hospital system that wanted and recruited cheap, malleable workers; this was not an attractive choice for demobbed nursing sisters. The chapter argues that despite nursing being a female dominated profession, the ideology that encouraged women to return to the home in the aftermath of war had significant ramifications for demobilised nurses. The social structure precluded married women from working outside the home and funds for postgraduate training available to returning male doctors were not offered to nurses. As the chapter maintains, most nursing sisters married, leaving the profession without their considerable talents and new ways of practicing.