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Medical culture and identity in provincial England, c.1760–1850
Author: Michael Brown

This book talks about late eighteenth- and early nineteenth-century English medical culture, a study of what it meant to be a doctor and how this changed over time. It presents a brief overview of the social, economic and cultural landscape of late eighteenth-century York. Medical culture and identity in late eighteenth-century York took shape within a social landscape shaped by the values of gentility, polite sociability and civic belonging. The book examines the role of intellectual liberality, demonstrating how public displays of polite and 'ornamental' learning were central to the performance of medico-gentility. It explores the incipient demise of this culture. Through a close reading of a scandal which enveloped the York Lunatic Asylum, it also explores the ways in which medical identities founded upon gentility and politeness were critically undermined by the political and social factionalism. The book looks at medical involvement in the provincial scientific movement, examining how local medical men positioned themselves relative to the so-called 'march of intellect', the cultural and ideological alignment between science and social reform. It continues this analysis in relation to the cholera epidemic of 1832 and other medico-political activities. The book considers how the professional dominion over healthcare was forged by the dual processes of inclusion and exclusion. It discusses the foundation of the Medical School in 1834 against the trial, in the same year, of a local salesman for James Morison's 'Universal Vegetable Medicine'.

Future crafting in the genomic era
Series: Inscriptions

What does it mean to personalise cancer medicine? Personalised cancer medicine explores this question by foregrounding the experiences of patients, carers and practitioners in the UK. Drawing on an ethnographic study of cancer research and care, we trace patients’, carers’ and practitioners’ efforts to access and interpret novel genomic tests, information and treatments as they craft personal and collective futures. Exploring a series of case studies of diagnostic tests, research and experimental therapies, the book charts the different kinds of care and work involved in efforts to personalise cancer medicine and the ways in which benefits and opportunities are unevenly realised and distributed. Investigating these experiences against a backdrop of policy and professional accounts of the ‘big’ future of personalised healthcare, the authors show how hopes invested and care realised via personalised cancer medicine are multifaceted, contingent and, at times, frustrated in the everyday complexities of living and working with cancer. Tracing the difficult and painstaking work involved in making sense of novel data, results and predictions, we show the different futures crafted across policy, practice and personal accounts. This is the only book to investigate in depth how personalised cancer medicine is reshaping the futures of cancer patients, carers and professionals in uneven and partial ways. Applying a feminist lens that focuses on work and care, inclusions and exclusions, we explore the new kinds of expertise, relationships and collectives involved making personalised cancer medicine work in practice and the inconsistent ways their work is recognised and valued in the process.

Chronic disease and clinical bureaucracy in post-war Britain
Author: Martin D. Moore

Through a study of diabetes care in post-war Britain, this book is the first historical monograph to explore the emergence of managed medicine within the National Health Service. Much of the extant literature has cast the development of systems for structuring and reviewing clinical care as either a political imposition in pursuit of cost control or a professional reaction to state pressure. By contrast, Managing Diabetes, Managing Medicine argues that managerial medicine was a co-constructed venture between profession and state. Despite possessing diverse motives – and though clearly influenced by post-war Britain’s rapid political, technological, economic, and cultural changes – general practitioners (GPs), hospital specialists, national professional and patient bodies, a range of British government agencies, and influential international organisations were all integral to the creation of managerial systems in Britain. By focusing on changes within the management of a single disease at the forefront of broader developments, this book ties together innovations across varied sites at different scales of change, from the very local programmes of single towns to the debates of specialists and professional leaders in international fora. Drawing on a broad range of archival materials, published journals, and medical textbooks, as well as newspapers and oral histories, Managing Diabetes, Managing Medicine not only develops fresh insights into the history of managed healthcare, but also contributes to histories of the NHS, medical professionalism, and post-war government more broadly.

Audrey Cruse

In ancient Greece and Rome magical and religious healing continued to be practised at the same time as a burgeoning of research and learning in the natural sciences was promoting a seemingly more rational and scientific approach to medicine. Was there, then, a dichotomy in medical treatment or was the situation more complex? This paper draws on historical textual sources as well as archaeological research in examining the question in more detail. Some early texts, such as the Egyptian papyri from about 2,600 bc and the Hippocratic Corpus from the third and fourth centuries bc, contain an intriguing mixture of scientific and religious material. Archaeological evidence from, for example, sites of healing sanctuaries from ancient times, show medical prescriptions used as part of votive offerings and religious inscriptions on surgical instruments, while physicians were prominent among donators to shrines. Other archaeological finds such as the contents of rubbish tips, buried hoards, sepulchral deposits and stray artefacts from occupation levels, have also added to the archive of medical material available for discussion. The paper concludes that such intertwinings of religion and science were not only common in Roman medicine but, in fact, continue into the present time.

Bulletin of the John Rylands Library
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How Chinese medicine became efficacious only for chronic conditions
Eric I. Karchmer

7 Slow medicine: how Chinese medicine became efficacious only for chronic conditions Eric I. Karchmer For many observers outside China, the efficacy of Chinese medicine remains in doubt or is only now just tentatively being confirmed by double blind clinical trials for a few specific interventions. Inside China, the picture is more complicated. Although there is no shortage of detractors, who reject Chinese medicine as a superstitious practice with little clinical merit, large numbers of people seem to accept the efficacy of Chinese medicine as well established

in Historical epistemology and the making of modern Chinese medicine
Editor: Howard Chiang

This collection expands the history of Chinese medicine by bridging the philosophical concerns of epistemology and the history and cultural politics of transregional medical formations. Topics range from the spread of gingko’s popularity from East Asia to the West to the appeal of acupuncture for complementing in-vitro fertilization regimens, from the modernization of Chinese anatomy and forensic science to the evolving perceptions of the clinical efficacy of Chinese medicine.

The individual essays cohere around the powerful theoretical-methodological approach, “historical epistemology,” with which scholars in science studies have already challenged the seemingly constant and timeless status of such rudimentary but pivotal dimensions of scientific process as knowledge, reason, argument, objectivity, evidence, fact, and truth. Yet given that landmark studies in historical epistemology rarely navigate outside the intellectual landscape of Western science and medicine, this book broadens our understanding of its application and significance by drawing on and exploring the rich cultures of Chinese medicine. In studying the globalizing role of medical objects, the contested premise of medical authority and legitimacy, and the syncretic transformations of metaphysical and ontological knowledge, contributors illuminate how the breadth of the historical study of Chinese medicine and its practices of knowledge-making in the modern period must be at once philosophical and transnational in scope.

This book will appeal to students and scholars working in science studies and medical humanities as well as readers who are interested in the broader problems of translation, material culture, and the global circulation of knowledge.

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Murderous Midwives and Homicidal Obstetricians
Diana Pérez Edelman

Ever since the publication of Frankenstein, the Gothic has been read as an expression of the fears associated with scientific, technological, and medical advances. This essay argues that obstetrical medicine, from midwifery to obstetrics, is the most Gothic of medical pursuits because of its blurring of boundaries between male and female, natural and supernatural, mechanical and organic, life and death. From subterraneous passages to monstrosity, the professionalization of obstetrics over the course of the eighteenth century and into the nineteenth reads like a Gothic novel. Tracing the parallels between the Gothic aesthetic and several fictional and quasifictional accounts of obstetrical ‘stories’ - from the Warming Pan Scandal of 1688 to the work of Scottish obstetrician William Smellie and man mid-wife William Hunter - this essay demonstrates the Gothic nature of reproductive pursuits.

Gothic Studies
Trade, conquest and therapeutics in the eighteenth century

Medicine was transformed in the eighteenth century. Aligning the trajectories of intellectual and material wealth, this book uncovers how medicine acquired a new materialism as well as new materials in the context of global commerce and warfare. It studies the expansion of medicine as it acquired new materials and methods in an age of discovery and shows how eighteenth-century therapeutics encapsulates the intellectual and material resources of conquest. Bringing together a wide range of sources, the book argues that the intellectual developments in European medicine were inextricably linked to histories of conquest, colonisation and the establishment of colonial institutions. Medicine in the eighteenth-century colonies was shaped by the two main products of European mercantilism: minerals and spices. Forts and hospitals were often established as the first signs of British settlement in enemy territories, like the one in Navy Island. The shifting fortunes on the Coromandel Coast over the eighteenth century saw the decline of traditional ports like Masulipatnam and the emergence of Madras as the centre of British trade. The book also explores the emergence of materia medica and medical botany at confluence of the intellectual, spiritual and material quests. Three different forms of medical knowledge acquired by the British in the colonies: plants (columba roots and Swietenia febrifuga), natural objects and indigenous medical preparations (Tanjore pills). The book examines the texts, plants, minerals, colonial hospitals, dispensatories and the works of surgeons, missionaries and travellers to demonstrate that these were shaped by the material constitution of eighteenth century European colonialism.

Rosalie David

Ancient medical and healing systems are currently attracting considerable interest. This issue includes interdisciplinary studies which focus on new perceptions of some ancient and medieval medical systems, exploring how they related to each other, and assessing their contribution to modern society. It is shown that pre-Greek medicine included some rational elements, and that Egyptian and Babylonian medical systems contributed to a tradition which led from classical antiquity through the Middle Ages and beyond. The reliability of sources of evidence is considered, as well as the legacy of the ancient healing environments (temples and healing sanctuaries) and disease treatments (including surgical procedures and pharmaceutical preparations). Finally, where documentation survives, the legacy of social attitudes to health and disease is considered. Overarching principles directed policies of social medicine and healthcare in antiquity and the Middle Ages: for example, the causes and transmission routes of infectious diseases, as well as the basic principles of sterilization, were unknown, but nevertheless attempts were made to improve sanitation, provide clean water, and ensure access to trained physicians. In some cases, the need to limit the size of the population prompted the use of contraceptive measures, and surviving information also illuminates attitudes to deformity, disability and the treatment of the terminally ill.

Bulletin of the John Rylands Library