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Performing medicine

Medical culture and identity in provincial England, c.1760–1850

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'.

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Materials and medicine

Trade, conquest and therapeutics in the eighteenth century

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Pratik Chakrabarti

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.

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Managing diabetes, managing medicine

Chronic disease and clinical bureaucracy in post-war Britain

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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.

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Missionaries and their medicine

A Christian modernity for tribal India

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David Hardiman

In November 1880 the Reverend Charles Thompson arrived at Kherwara, Rajasthan, India, to establish the first Anglican mission to the Bhils, a primitive tribe, by going amongst them as a healer. This book sets out the history of the interaction between the missionaries and the Bhils, a history of missionary medicine, and how certain Bhils forged their own relationship with modernity. During the 1870s, the Church Missionary Society declared its intention to open more missions 'among the non-Aryan hill-people', and the Bishop of Lahore wanted more missions to work amongst the 'aboriginal' Bhils. A great famine that began in 1899 brought radical changes in the mission to the Bhils. After the famine, many of the Bhagats, a local sect, became convinced that the sinless deity was the God of Christians, and they decided to convert en masse to Christianity. The missionaries working amongst the Bhils believed that Satan was in their midst, who was constantly enticing their hard-won converts to relinquish their new faith and revert to their 'heathen' ways. It was argued that 'heathen' beliefs and culture could be attacked only if female missionaries were required to work with native women. Mission work had always been hampered by a lack of funds, and at one time, the hospital at Lusadiya had to dissuade many would-be inpatients from coming for treatment due to lack of beds. The book also deals with the work of the mission in the post-colonial India, which laid more stress to healing than evangelism.

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Medicine, mobility and the empire

Nyasaland networks, 1859–1960

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Markku Hokkanen

David Livingstone's Zambesi expedition marked the beginning of an ongoing series of medical exchanges between the British and Malawians. This book explores these entangled histories by placing medicine in the frameworks of mobilities and networks that extended across Southern Africa and beyond. It argues that mobility was a crucial aspect of intertwined medical cultures that shared a search for therapy in changing conditions. The Malawi mission stations were the first permanent sites in which Western medicine was made available to Africans. Livingstonia's medical practice began in Cape Maclear in 1875, moved to Bandawe in the early 1880s and expanded to Ngoniland and north Lake Malawi. Lacking effective therapies to deal with the high levels of ill health and morbidity that plagued them, Europeans sometimes sought out cures and protection from indigenous African, Asian and American healers, many of whom were women. The lay practice of 'doctoring' African employees with elements of trickery continued into the later colonial period. Medical middles were among the most mobile individuals in colonial Southern Africa, moving as they did between mission, government and private sector employment, and across local and regional boundaries. The Second World War brought about major changes in the types of antimalarials available in the Nyasaland Protectorate and the wider empire, as quinine became a scarcer resource and new synthetic anti-malarials became more available. Western medicine became recognised as one resource among others in a pluralistic medical culture, but African medicine, for Europeans, became mainly an object of ethnographical and anthropological interest.

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Edited by: David Arnold

In recent years it has become apparent that the interaction of imperialism with disease, medical research, and the administration of health policies is considerably more complex. This book reflects the breadth and interdisciplinary range of current scholarship applied to a variety of imperial experiences in different continents. Common themes and widely applicable modes of analysis emerge include the confrontation between indigenous and western medical systems, the role of medicine in war and resistance, and the nature of approaches to mental health. The book identifies disease and medicine as a site of contact, conflict and possible eventual convergence between western rulers and indigenous peoples, and illustrates the contradictions and rivalries within the imperial order. The causes and consequences of this rapid transition from white man's medicine to public health during the latter decades of the nineteenth and early years of the twentieth centuries are touched upon. By the late 1850s, each of the presidency towns of Calcutta, Bombay and Madras could boast its own 'asylum for the European insane'; about twenty 'native lunatic asylums' had been established in provincial towns. To many nineteenth-century British medical officers smallpox was 'the scourge of India'. Following the British discovery in 1901 of a major sleeping sickness epidemic in Uganda, King Leopold of Belgium invited the recently established Liverpool School of Tropical Medicine to examine his Congo Free State. Cholera claimed its victims from all levels of society, including Americans, prominent Filipinos, Chinese, and Spaniards.

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Edited by: Andrew Cunningham and Bridie Andrews

Medicine has always been a significant tool of an empire. This book focuses on the issue of the contestation of knowledge, and examines the non-Western responses to Western medicine. The decolonised states wanted Western medicine to be established with Western money, which was resisted by the WHO. The attribution of an African origin to AIDS is related to how Western scientists view the disease as epidemic and sexually threatening. Veterinary science, when applied to domestic stock, opens up fresh areas of conflict which can profoundly influence human health. Pastoral herd management was the enemy of land enclosure and efficient land use in the eyes of the colonisers. While the native Indians of the United States were marginal participants in the delivery or shaping of health care, the Navajo passively resisted Western medicine by never giving up their own religion-medicine. The book discusses the involvement of the Rockefeller Foundation in eradicating the yellow fever in Brazil and hookworm in Mexico. The imposition of Western medicine in British India picked up with plague outbreaks and enforced vaccination. The plurality of Indian medicine is addressed with respect to the non-literate folk medicine of Rajasthan in north-west India. The Japanese have been resistant to the adoption of the transplant practices of modern scientific medicine. Rumours about the way the British were dealing with plague in Hong Kong and Cape Town are discussed. Thailand had accepted Western medicine but suffered the effects of severe drug resistance to the WHO treatment of choice in malaria.

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Vanessa Heggie

Athletes start the century as normal, healthy citizens, and end up as potentially unhealthy physiological 'freaks', while the general public are increasingly urged to do more exercise and play more sports. This book offers a comprehensive study, and social history, of the development of sports medicine in Britain, as practiced by British doctors and on British athletes in national and international settings. It describes how and why, in Britain, medicine applied to sport became first an area of expertise known as sports medicine, and then a formal medical specialty: Sport and Exercise Medicine. In the late nineteenth century, vigorous exercise was an acceptable, probably necessary, part of the moderate healthy lifestyle for the normal, healthy man. Consequently sports medicine was part and parcel of normal medical treatment, distinguishable only through its location or through its patient history. There was no wide-spread de facto scepticism about the value of vigorous exercise among physicians and scientists. The normality of the young male athlete is reconsidered between 1928 and 1952. At the end of the period, the athlete becomes an abnormal or supernormal human being who demands specialist medical interventions. The formation and work of British Association of Sport and (Exercise) Medicine, the Institute of Sports Medicine, the Sports Council, and the British Olympic Association's Medical Committee is discussed. The book finally discusses fitness. Normal life, war, elite competition gives us an insight into how athletic bodies are conceptualised, and how sports medicine has formed and reformed over a century.

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Slow medicine

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

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Edited by: John Cunningham

This collection offers important new insights across a broad range of topics relating to medicine in Early Modern Ireland. Of particular note is the substantial attention devoted to the years before 1750, a period that has been relatively neglected in studies of Irish medicine. The book brings together an exciting selection of established scholars, such as Peter Elmer and Clodagh Tait, as well as a number of early career historians. Their work effectively situates Irish medicine in relation to long-term social and cultural change on the island, as well as to appropriate international contexts, encompassing Britain, Europe and the Atlantic World. The chapters also engage in various ways with important aspects of the historiography of medicine in the twenty-first century. Among the key subjects addressed by the contributors are Gaelic medicine, warfare, the impact of new medical ideas, migration, patterns of disease, midwifery and childbirth, book collecting, natural history, and urban medicine. A common thread running through the chapters is the focus on medical practitioners. The book accordingly enables significant new understanding of the character of medical practise in Early Modern Ireland. This collection will be of interest to academics and students of the history of Early Modern medicine. It also contains much that will be essential reading for historians of Ireland.