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Editors: Anne Hanley and Jessica Meyer

In 1985 Roy Porter called for patients to be retrieved from the margins of history because, without them, our understanding of illness and healthcare would remain distorted. But despite concerted efforts, the innovation that Porter envisaged has not come to pass.

Patient voices in Britain repositions the patient at the centre of healthcare histories. By prioritising the patient’s perspective in the century before the foundation of the National Health Service, this edited collection enriches our understanding of healthcare in the context of Britain’s emerging welfare state. Encompassing topics like ethical archival practice, life within institutions, user-driven medicine and the impact of shame and stigma on health outcomes, its chapters encourage historians to reimagine patienthood. It provides a model for using new sources and reading familiar sources in new ways. And, exploring traditional clinical spaces and beyond, it interrogates what it meant to be a patient and how this has changed over time.

Crucially, the collection also aims to help historians locate and develop policy relevance within their work, reflecting on how these historical tensions continue to shape attitudes towards health, illness and the clinical encounter. Each chapter presents a framework for using history to speak to pressing policy issues.

Open Access (free)
Sex, family planning and British female doctors in transnational perspective, 1920–70

Women’s medicine explores the key role played by British female doctors in the production and circulation of contraceptive knowledge and the handling of sexual disorders between the 1920s and 1970s at the transnational level, taking France as a point of comparison. This study follows the path of a set of women doctors as they made their way through the predominantly male-dominated medical landscape in establishing birth control and family planning as legitimate fields of medicine. This journey encompasses their practical engagement with birth control and later family planning clinics in Britain, their participation in the development of the international movement of birth control and family planning and their influence on French doctors. Drawing on a wide range of archived and published medical materials, this study sheds light on the strategies British female doctors used, and the alliances they made, to put forward their medical agenda and position themselves as experts and leaders in birth control and family planning research and practice.

A history of child development in Britain
Author: Bonnie Evans

This book explains the current fascination with autism by linking it to a longer history of childhood development. Drawing from a staggering array of primary sources, it traces autism back to its origins in the early twentieth century and explains why the idea of autism has always been controversial and why it experienced a 'metamorphosis' in the 1960s and 1970s. The book locates changes in psychological theory in Britain in relation to larger shifts in the political and social organisation of schools, hospitals, families and childcare. It explores how government entities have dealt with the psychological category of autism. The book looks in detail at a unique children's 'psychotic clinic' set up in London at the Maudsley Hospital in the 1950s. It investigates the crisis of government that developed regarding the number of 'psychotic' children who were entering the public domain when large long-stay institutions closed. The book focuses on how changes in the organisation of education and social services for all children in 1970 gave further support to the concept of autism that was being developed in London's Social Psychiatry Research Unit. It also explores how new techniques were developed to measure 'social impairment' in children in light of the Seebohm reforms of 1968 and other legal changes of the early 1970s. Finally, the book argues that epidemiological research on autism in the 1960s and 1970s pioneered at London's Institute of Psychiatry has come to define global attempts to analyse and understand what, exactly, autism is.

The past, present and future of hospital infection, prevention and control

Infection control is one of the twenty-first century’s most challenging health problems, as witnessed by global debates about microbial resistance and several high-profile hospital infection scandals. This interdisciplinary volume brings together work from leading historians, researchers, healthcare professionals and policy makers to consider the history, practice and future of hospital infection control in the UK. Through personal reflections, historical case studies, policy debates and accounts of specific hospitals this volume explores the roles of technology, healthcare professions, emotional attitudes, and human factors and ergonomics in the translation of scientific knowledge into clinical practice. These insights into the theory and practice of infection control in the operating room, bedside, laboratory and boardroom, provide vital reading not only for historians of medicine, practitioners and policy makers, but also for researchers in the arts, humanities and social sciences.

Open Access (free)
Medicine and culture in the nineteenth century

This collaborative volume explores changing perceptions of health and disease in the context of the burgeoning global modernities of the long nineteenth century. During this period, popular and medical understandings of the mind and body were challenged, modified, and reframed by the politics and structures of ‘modern life’, understood in industrial, social, commercial, and technological terms. Bringing together work by leading international scholars, this volume demonstrates how a multiplicity of medical practices were organised around new and evolving definitions of the modern self. The study offers varying and culturally specific definitions of what constituted medical modernity for practitioners around the world in this period. Chapters examine the ways in which cancer, suicide, and social degeneration were seen as products of the stresses and strains of ‘new’ ways of living in the nineteenth century, and explore the legal, institutional, and intellectual changes that contributed to both positive and negative understandings of modern medical practice. The volume traces the ways in which physiological and psychological problems were being constituted in relation to each other, and to their social contexts, and offers new ways of contextualising the problems of modernity facing us in the twenty-first century.

Open Access (free)
Mass vaccination and the public since the Second World War
Author: Gareth Millward

Vaccinating Britain investigates the relationship between the British public and vaccination policy since 1945. It is the first book to examine British vaccination policy across the post-war period and covers a range of vaccines, providing valuable context and insight for those interested in historical or present-day public health policy debates. Drawing on government documents, newspapers, internet archives and medical texts it shows how the modern vaccination system became established and how the public played a key role in its formation. British parents came to accept vaccination as a safe, effective and cost-efficient preventative measure. But occasional crises showed that faith in the system was tied to contemporary concerns about the medical profession, the power of the state and attitudes to individual vaccines. Thus, at times the British public demanded more comprehensive vaccination coverage from the welfare state; at others they eschewed specific vaccines that they thought were dangerous or unnecessary. Moreover, they did not always act uniformly, with “the public” capable of expressing contradictory demands that were often at odds with official policy. This case study of Britain’s vaccination system provides insight into the relationship between the British public and the welfare state, as well as contributing to the historiography of public health and medicine.

From England to the Mediterranean

The chapters in this volume, by established scholars and early-career researchers in history and archaeology, shed new light on the identities and experiences of people affected by leprosy (Hansen’s disease) in medieval western Europe. Building on recent research that challenges the view that people with leprosy were excluded and stigmatised, the book demonstrates the complex and varying status of the illness and its sufferers. The authors provide case studies from Italy, Germany, France and England between the eleventh and fifteenth centuries, with some chapters adding a broader global perspective. The source material includes archival documents, archaeological data, hagiography and artworks. The book makes a new contribution to our understanding of social provision for people with leprosy, with chapters exploring how leprosy hospitals sat at the boundary between integration and segregation. It also describes how some sufferers lived outside institutional settings. The central question of identity enables consideration of how people with leprosy related to each other, and the extent to which their lives were transformed by the disease. While leprosy had a significant impact on social, professional and religious identities, people retained aspects of their previous identities after developing the condition. Furthermore, the collective identity of leprosy sufferers was shared by individuals who were labelled ‘lepers’ but did not have the illness. The book reveals the cultural and social significance of leprosy, a disease with deep metaphorical and spiritual associations. It also demonstrates how people with leprosy exerted their agency, although their perspectives are usually absent from the sources.

Author: Steven King

This book explores the experiences of the sick poor between the 1750s and through the so-called crisis of the Old Poor Law ending in the 1830s. It provides a comprehensive and colourful overview of the nature, scale and negotiation of medical welfare. At its core stand the words and lives of the poor themselves, reconstructed in painstaking detail to show that medical welfare became a totemic issue for parochial authorities by the 1830s. The book suggests that the Old Poor Law confronted a rising tide of sickness by the early nineteenth century. While there are spectacular instances of parsimony and neglect in response to rising need, in most places and at most times, parish officers seem to have felt moral obligations to the sick. Indeed, we might construct their responses as considerate and generous. To some extent this reflected Christian paternalism but also other factors such as a growing sense that illness, even illness among the poor, was and should be remediable and a shared territory of negotiation between paupers, advocates and officials. The result was a canvas of medical welfare with extraordinary depth. By the 1820s, more of the ill-health of ordinary people was captured by the poor law and being doctored or sojourning in an institution became part of pauper and parochial expectation. These trends are brought to vivid life in the words of the poor and their advocates, such that the book genuinely offers a re-interpretation of the Old Poor Law from the bottom up.

Open Access (free)
Medicine, politics and the regulation of health in the twentieth century

Concepts of ‘balance’ have been central to modern politics, medicine and society. Yet, while many health, environmental and social challenges are discussed globally in terms of imbalances in biological, social and ecological systems, strategies for addressing modern excesses and deficiencies have focused almost exclusively on the agency of the individual. Balancing the Self explores the diverse ways in which balanced and unbalanced selfhoods have been subject to construction, intervention and challenge across the long twentieth century. Through original chapters on subjects as varied as obesity control, fatigue and the regulation of work, and the physiology of exploration in extreme conditions, the volume analyses how concepts of balance and rhetorics of empowerment and responsibility have historically been used for a variety of purposes, by a diversity of political and social agencies. Historicising present-day concerns, as well as uncovering the previously hidden interests of the past, this volume’s wide-ranging discussions of health governance, subjectivity and balance will be of interest to historians of medicine, sociologists, social policy analysts, and social and political historians alike.

When physicians gathered in medical societies to present, share, discuss, evaluate, publish and even celebrate their medical studies, they engaged in a community with specific practices, rules and manners. This book explores the formal and subtle ways in which such norms were set. It analyzes societies’ scientific publishing procedures, traditions of debate, (inter)national networks, and social and commemorative activities, uncovering a rich scientific culture in nineteenth-century medicine. The book focuses on medical societies in Belgium, a young nation-state eager to take its place among the European nations, in which the constitutional freedoms of press and association offered new possibilities for organized sociability. It situates medical societies within an emerging civil culture in Ghent, Brussels and Antwerp, and shows how physicians’ ambitions to publish medical journals and organize scientific debates corresponded well to the values of social engagement, polite debate and a free press of the urban bourgeoisie. As such, this book offers new insights into the close relation between science, sociability and citizenship. The development of a professional academic community in the second half of the century, which centered around the laboratory, went hand in hand with a set of new scientific codes, mirroring to a lesser extent the customs of civil society. It meant the end of a tradition of ‘civil’ science, forcing medical societies to reposition themselves in the scientific landscape, and take up new functions as mediators between specialties and as centers of postgraduate education.